A higher cumulative modified Life's Essential 8 score over 8 years was associated with slower rates of decline in global cognition, executive function, memory, and orientation in later life.
Key Findings
Results
A per standard deviation increase in cumulative modified LE8 score was associated with slower rate of decline in global cognition.
Pooled Beta = 0.089 SD/year for global cognition
Results were derived from pooled analysis of two longitudinal cohorts: HRS (n=1345) and ELSA (n=2865)
The cumulative LE8 score was calculated using 8 years of LE8 assessments
Linear mixed models were used to examine the association between cumulative modified LE8 score and cognitive change
Results from HRS and ELSA demonstrated general consistency
Results
A per standard deviation increase in cumulative modified LE8 score was associated with slower rate of decline in executive function.
Pooled Beta = 0.093 SD/year for executive function
This was the largest effect size observed among all cognitive domains examined
Analysis was conducted using linear mixed models across both cohorts
Results
A per standard deviation increase in cumulative modified LE8 score was associated with slower rate of decline in memory.
Pooled Beta = 0.050 SD/year for memory
Memory was one of four cognitive outcomes assessed in the pooled analysis
The association was consistent across both HRS and ELSA cohorts
Results
A per standard deviation increase in cumulative modified LE8 score was associated with slower rate of decline in orientation.
Pooled Beta = 0.040 SD/year for orientation
Orientation showed the smallest effect size among the four cognitive domains examined
Results were pooled across the HRS and ELSA longitudinal cohorts
Methods
The modified LE8 score was constructed from seven health factors rather than the original eight, excluding diet due to data unavailability.
The seven components included were: sleep, physical activity, smoking, body mass index, blood lipids, blood glucose, and blood pressure
Diet was excluded from the modified LE8 score construction
The cumulative score was derived from repeated assessments over an 8-year period
This modified scoring approach was applied consistently across both the HRS and ELSA cohorts
Methods
Two large longitudinal cohort studies were used, comprising a combined total of 4,210 participants.
HRS (Health and Retirement Study) contributed 1,345 participants
ELSA (English Longitudinal Study of Ageing) contributed 2,865 participants
Both cohorts focused on older adult populations
The study design allowed for examination of cumulative cardiovascular health exposure over 8 years in relation to cognitive trajectories
Conclusions
Higher cumulative cardiovascular health scores were associated with better late-life cognition, supporting the importance of long-term maintenance of optimal cardiovascular health.
The study extended prior cross-sectional and baseline LE8 findings by examining cumulative rather than single-timepoint exposure
The authors highlight that prior research showed higher baseline LE8 score is linked to better cognitive performance and slower decline, but cumulative effects had been unclear
Findings highlight 'the importance of maintaining long-term optimal cardiovascular health for preventing cognitive decline'
What This Means
This research suggests that maintaining good cardiovascular health over many years is linked to slower cognitive decline in older adults. The study tracked over 4,000 older adults from the United States (Health and Retirement Study) and England (English Longitudinal Study of Ageing) and measured their cardiovascular health across 8 years using a score based on seven lifestyle and health factors: sleep, physical activity, smoking, body weight, blood fats, blood sugar, and blood pressure. Researchers then examined how this cumulative health score related to changes in thinking and memory abilities over time.
The findings showed that people with higher cumulative cardiovascular health scores experienced slower decline across multiple areas of cognitive function, including overall thinking ability, executive function (planning and decision-making), memory, and orientation. The effect was consistent across both cohorts and across all cognitive domains studied, with executive function showing the strongest association. These results build on previous research that looked only at cardiovascular health at a single point in time, by showing that the sustained maintenance of healthy behaviors and health metrics over years appears to matter for brain health.
This research suggests that keeping cardiovascular risk factors well-managed over the long term — not just at one point in time — may help protect cognitive function as people age. The consistency of results across two different national cohorts (U.S. and England) strengthens confidence in these findings. The study underscores the potential value of public health efforts aimed at promoting sustained healthy lifestyles in middle and older age as a strategy for reducing the burden of cognitive decline.
Dai Y, Liu Y, Pan Y, Zhu M, Diao X, Yang X, et al.. (2026). Association of the cumulative modified life's Essential 8 score with cognitive change: Results from two longitudinal cohorts.. The journal of prevention of Alzheimer's disease. https://doi.org/10.1016/j.tjpad.2026.100548