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Chris Power, PhD, Barbara J. M. H. Jefferis, PhD and Orly Manor, PhD

At the time of the study, Chris Power and Barbara J. M. H. Jefferis were with the Medical Research Council Centre of Epidemiology for Child Health, University College London Institute of Child Health, London, UK. Orly Manor is with the School of Public Health and Community Medicine, The Hebrew University, Hadassah Medical Organization, PO Box 12272, Jerusalem 91120, Israel.

Correspondence: Correspondence should be sent to Professor Chris Power, MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, 30 Guilford St, London, WC1N 1EH, UK (e-mail: c.power{at}ich.ucl.ac.uk). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We sought to establish whether associations between childhood cognition and risk factors for cardiovascular disease in adulthood are explained by common causes, or adult social position or health behavior.

Methods. We analyzed associations between cognition at age 11 and cardiovascular disease risk factors at age 45 in the 1958 British birth cohort (n = 9377), with and without adjustment for covariates.

Results. General ability was inversely associated with systolic and diastolic blood pressure, glycosylated hemoglobin, triglycerides (in women), body mass index, and waist circumference. Systolic blood pressure decreased by 0.47 mm Hg (95% confidence interval [CI] = –0.90, –0.05) for a 1-standard-deviation increase in ability. Separate adjustment for social class at birth, education level by adulthood, adult social class, and health behaviors reduced the associations respectively by 14% to 34%, 36% to 50%, 14% to 36%, and 24% to 73%. Full adjustment reduced associations between ability and risk factors at age 45 years by 43% to 92%, abolishing all associations.

Conclusions. Increments across the distribution of childhood cognition are associated with improvements in cardiovascular risk profile in midlife, with associations primarily mediated through adult health behavior and social destinations.