We found that HRF was significantly associated with cognitive performance (higher HRF, worse cognitive performance) independent of a combination of widely acknowledged risk factors of cognitive impairment including demographic (age, sex), socioeconomic (level of education, gross family income), genomic (APOE-ε4 allele), behavioral (smoking, alcohol consumption, degree of physical activity), mental health (depression) variables, and CV risk factors (hypertension, hyperlipidemia, diabetes and CAC). This evidence concerns the gene APOE and depressive symptom measurement.