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The association of pre-cancer diagnosis cardiovascular risk factors with memory aging after a cancer diagnosis, overall and by race/ethnicity

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Abstract

Purpose

Cardiovascular risk factors (CVRFs) are associated with increased risk for cognitive impairment and decline in the general population, but less is known about how CVRFs might influence cognitive aging among older cancer survivors. We aimed to determine how CVRFs prior to a cancer diagnosis affect post-cancer diagnosis memory aging, compared to cancer-free adults, and by race/ethnicity.

Methods

Incident cancer diagnoses and memory (immediate and delayed recall) were assessed biennially in the US Health and Retirement Study (N = 5,736, 1998–2018). CVRFs measured at the wave prior to a cancer diagnosis included self-reported cigarette smoking, obesity, diabetes, heart disease, hypertension, and stroke. Multivariable-adjusted linear mixed-effects models evaluated the rate of change in standardized memory score (SD/decade) post-cancer diagnosis for those with no, medium, and high CVRFs, compared to matched cancer-free adults, overall and stratified by sex and race/ethnicity.

Results

Higher number of CVRFs was associated with worse baseline memory for both men and women, regardless of cancer status. Cancer survivors with medium CVRFs had slightly slower rates of memory decline over time relative to cancer-free participants (0.04 SD units/decade [95% CI: 0.001, 0.08]). Non-Hispanic Black (NHB) and Hispanic cancer-free participants and cancer survivors had worse baseline memory than their Non-Hispanic White (NHW) counterparts.

Conclusions

CVRFs were associated with worse baseline memory function, but not decline, for cancer-free adults and cancer survivors. Racial disparities were largely similar between cancer survivors and cancer-free adults.

Implications for Cancer Survivors

These findings may inform hypotheses about pre-diagnosis multimorbidity and cognitive aging of cancer survivors from diverse groups.

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Funding

This work was supported by the National Institute on Aging Pathway to Independence Award (K99 AG076532) to Ashly C. Westrick.

Author information

Authors and Affiliations

  1. Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA

    Ashly C. Westrick, Peiyao Zhu & Lindsay C. Kobayashi

  2. Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA

    Christopher R. Friese

  3. School of Nursing, University of Michigan, Ann Arbor, MI, USA

    Christopher R. Friese

  4. Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA

    Christopher R. Friese & Lindsay C. Kobayashi

  5. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA

    Christopher R. Friese & Kenneth M. Langa

  6. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Kenneth M. Langa

  7. Institute for Social Research, University of Michigan, Ann Arbor, MI, USA

    Kenneth M. Langa

Authors
  1. Ashly C. Westrick
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  2. Peiyao Zhu
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  4. Kenneth M. Langa
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  5. Lindsay C. Kobayashi
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Contributions

All authors contributed to the study conception and design. Material preparation, data management and analyses were performed by A.C.W and P.Z. The first draft of the manuscript was written by A.C.W. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ashly C. Westrick.

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Westrick, A.C., Zhu, P., Friese, C.R. et al. The association of pre-cancer diagnosis cardiovascular risk factors with memory aging after a cancer diagnosis, overall and by race/ethnicity. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01593-4

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