Association of the cumulative modified Life’s Essential 8 score with cognitive change: results from two longitudinal cohorts - 17/03/26

Doi : 10.1016/j.tjpad.2026.100548

Yiwen Dai ¹, Yuling Liu ¹, Yang Pan ¹, Menghan Zhu ¹, Xuyang Diao ¹, Xinqing Yang ¹, Jingya Ma ¹, Darui Gao ^2,^3,⁴, Yanyu Zhang ^2,^3,⁴, Mengmeng Ji ^2,^3,⁴, Yichi Zhang ^2,^3,⁴, Wuxiang Xie ^2,^3,^4,^⁎ , Fanfan Zheng ^1,^⁎

¹ School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

² Department of Endocrinology, Peking University First Hospital, Beijing, China

³ Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, Beijing, China

⁴ Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China

^⁎ Corresponding Authors: Wuxiang Xie, PhD, Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University; 38 Xueyuan Road, Haidian District, 100191, Beijing, China Clinical Research Institute Institute of Advanced Clinical Medicine Peking University 38 Xueyuan Road Haidian District Beijing 100191 China ^⁎⁎ Co-corresponding Authors: Fanfan Zheng, PhD, Department of Clinical Nursing, School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, 100144, Beijing, China, Telephone: +86-10-88771099 Department of Clinical Nursing School of Nursing Chinese Academy of Medical Sciences & Peking Union Medical College No. 33 Badachu Road Shijingshan District Beijing 100144 China

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Abstract

INTRODUCTION

Although a higher baseline Life’s Essential 8 (LE8) score is linked to better cognitive performance and slower decline, it remains unclear whether the cumulative LE8 score is associated with cognitive change in later life.

METHODS

We included 1345 participants from the Health and Retirement Study (HRS) and 2865 participants from the English Longitudinal Study of Ageing (ELSA). A modified LE8 score was constructed based on sleep, physical activity, smoking, body mass index, blood lipids, blood glucose, and blood pressure. The cumulative modified LE8 score was calculated using 8 years of LE8 assessments. The association between cumulative modified LE8 score and cognitive change was examined using the linear mixed model.

RESULTS

Results from the HRS and the ELSA demonstrated general consistency. Pooled analysis showed that a per SD increase in cumulative modified LE8 score was associated with a slower rate of decline in global cognition (pooled Beta=0.089 SD/year), executive function (pooled Beta=0.093 SD/year), memory (pooled Beta=0.050 SD/year), and orientation (pooled Beta=0.040 SD/year).

DISCUSSION

A higher cumulative modified LE8 score was associated with better late-life cognition, highlighting the importance of maintaining long-term optimal cardiovascular health for preventing cognitive decline.

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KEYWORDS : cardiovascular health, Life’s Essential 8, cumulative LE8, cognitive change, cohort study

List of abbreviations : AHA, BMI, CI, CVH, ELSA, HbA1c, HRS, IQR, LE8, LS7, MET, Non-HDL, PA, SD, VRFs