Association between cardiovascular and cognitive health among older Indigenous Africans: Data from an urban Nigerian settlement participating in the VALIANT study

Alzheimers Dement. 2025 Sep;21(9):e70669. doi: 10.1002/alz.70669.

ABSTRACT

INTRODUCTION: The relationship between cardiovascular health (CVH) and cognitive health (CH) has been established in diverse populations but is understudied among indigenous Africans. We investigated the association between CVH and CH in 1031 older Nigerian Africans participating in the Vascular heAlth, fraiLty, and cognItion in Ageing Nigerians sTudy (VALIANT).

METHODS: CVH was assessed by the Life's Simple 7 (LS7) score. CH was measured using three validated metrics of general cognitive well-being: Montreal Cognitive Assessment (MoCA), Community Screening Instrument for Dementia (CSID), and Identification and Intervention for Dementia in Elderly Africans (IDEA). Frailty was evaluated using Rockwood's Clinical Frailty Scale. Multivariable linear regression was performed.

RESULTS: Individual LS7 metrics, including poor diet, ideal body mass index (overall), and intermediate blood pressure (among female participants), showed independent relationships with poor CH. Although the LS7 composite score showed a significant univariate relationship with MoCA and IDEA scores, the independent determinants of general CH were older age, low educational attainment, and clinical frailty, but not LS7 composite score DISCUSSION: In a sample of older Nigerian Africans, the LS7 composite score may not accurately characterize the relationship between CVH and CH. Afrocentric CVH composite scores incorporating measures that are more sensitive to outcomes in Africans are needed.

HIGHLIGHTS: We determined the association between cardiovascular health (CVH) and cognitive health (CH) in 1031 urban-dwelling Nigerian Africans. Although individual Life's Simple 7 (LS7) metrics such as poor diet, intermediate blood pressure, and ideal body mass index showed independent association with poor CH, the composite LS7 metric showed no association. In a sample of Nigerian Africans, the LS7 score as a composite vascular marker may not accurately characterize the relationship between CVH and CH. Afrocentric composite scores incorporating risk markers potentially unique to indigenous African populations are needed for robust characterization of CVH.

PMID:40968689 | DOI:10.1002/alz.70669