Cognitive ability, lifestyle risk factors, and two-year survival in first myocardial infarction men : A Swedish National Registry study

Background: General cognitive ability (CA) is positively associated with later physical and mental health, health literacy, and longevity. We investigated whether CA estimated approximately 30 years earlier in young adulthood predicted lifestyle-related risk factors and two-year survival in first myocardial infarction (MI) male patients. Methods: Young adulthood CA estimated through psychometric testing at age 18–20 years was obtained from the mandatory military conscript registry (INSARK) and linked to national quality registry SWEDEHEART/RIKS-HIA data on smoking, diabetes, hypertension, obesity (BMI > 30 kg/m2) in 60 years or younger Swedish males with first MI. Patients were followed up in the Cause of Death registry. The 5659 complete cases (deceased = 106, still alive = 5553) were descriptively compared. Crude and adjusted associations were modelled with logistic regression. Results: After multivariable adjustment, one SD increase in CA was associated with a decreased odds ratio of being a current smoker (0.63 [0.59, 0.67], P < 0.001), previous smoker (0.79 [0.73, 0.84], P < 0.001), having diabetes (0.82 [0.74, 0.90], P < 0.001), being obese (0.90 [0.84, 0.95], P < 0.001) at hospital admission, and an increased odds ratio of two-year survival (1.26 [1.02, 1.54], P < 0.001). CA was not associated with hypertension at hospital admission (1.03 [0.97, 1.10], P = 0.283). Conclusions: This study found substantial inverse associations between young adulthood CA, and middle-age lifestyle risk factors smoking, diabetes, and obesity, and two-year survival in first MI male patients. CA assessment might benefit risk stratification and possibly aid further tailoring of secondary preventive strategy