Abstract
OBJECTIVE: Metabolic and vascular conditions have been independently associated with dementia and cognitive decline among older adults, but research on the combined effects that these conditions have on cognitive decline, especially among older Mexican Americans, is lacking. The purpose of this study was to examine the relationship between metabolic and vascular conditions and cognitive decline among older Mexican Americans. METHODS: The final sample included 2767 participants of the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Linear mixed-effects regression was used to model cognitive decline across six examinations (1993-2007) according to the number (zero, one, two, and three to four) of metabolic and vascular conditions (hypertension, diabetes, stroke, and heart attack). RESULTS: Of the 2767 participants included in the final sample, 777 had zero conditions, 1314 had one condition, 553 had two conditions, and 123 had three to four conditions. Participants with two or three to four conditions had significantly greater cognitive decline compared with participants with zero or one condition. Stroke had the largest effect size on cognitive decline based on the proportion of variance that stroke accounted for in the linear mixed-effects model. CONCLUSION: Mexican American older adults with multiple metabolic and vascular conditions exhibit greater cognitive decline than those with zero or one condition. Public health interventions designed to reduce the prevalence of chronic metabolic and vascular conditions, in particular stroke, may limit the severity of cognitive decline among older Mexican Americans.