Dataset Information

Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline.

ABSTRACT:

Background

The impact of cardiovascular risk burden on cognitive trajectories and brain structure changes remains unclear.

Objectives

This study aimed to examine whether cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) is associated with cognitive decline and structural brain differences.

Methods

Within the Rush Memory and Aging Project, 1,588 dementia-free participants (mean age: 79.5 years) were followed for up to 21 years. FGCRS was assessed at baseline and categorized into tertiles (lowest, middle, and highest). Episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed were assessed annually with a battery of 19 tests, from which composite scores were derived. A subsample (n = 378) of participants underwent magnetic resonance imaging. Structural total and regional brain volumes were estimated. Data were analyzed using linear mixed-effects models and linear regression models.

Results

In all participants, FGCRS ranged from 4 to 28 (mean score: 15.6 ± 3.7). Compared with the lowest tertile of FGCRS, the highest tertile was associated with faster decline in global cognition (β = -0.019; 95% confidence interval [CI]: -0.035 to -0.003), episodic memory (β = -0.023; 95% CI: -0.041 to -0.004), working memory (β = -0.021; 95% CI: -0.035 to -0.007), and perceptual speed (β = -0.027; 95% CI: -0.042 to -0.011) over the follow-up. In magnetic resonance imaging data analyses, higher FGCRS was related to smaller volumes of the hippocampus (β = -0.021; 95% CI: -0.042 to -0.000), gray matter (β = -1.569; 95% CI: -2.757 to -0.382), and total brain (β = -1.588; 95% CI: -2.832 to -0.344), and greater volume of white matter hyperintensities (β = 0.035; 95% CI: 0.001 to 0.069).

Conclusions

Higher cardiovascular risk burden may predict decline in episodic memory, working memory, and perceptual speed and is associated with neurodegeneration and vascular lesions in the brain.

SUBMITTER: Song R

PROVIDER: S-EPMC10061875 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Publications

Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline.

Song Ruixue R Xu Hui H Dintica Christina S CS Pan Kuan-Yu KY Qi Xiuying X Buchman Aron S AS Bennett David A DA Xu Weili W

Journal of the American College of Cardiology 20200501 20

<h4>Background</h4>The impact of cardiovascular risk burden on cognitive trajectories and brain structure changes remains unclear.<h4>Objectives</h4>This study aimed to examine whether cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) is associated with cognitive decline and structural brain differences.<h4>Methods</h4>Within the Rush Memory and Aging Project, 1,588 dementia-free participants (mean age: 79.5 years) were followed for up to 21 years. F ...[more]

PMID: 32439001

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Project description:ImportanceIncident stroke is associated with accelerated cognitive decline. Whether poststroke vascular risk factor levels are associated with faster cognitive decline is uncertain.ObjectiveTo evaluate associations of poststroke systolic blood pressure (SBP), glucose, and low-density lipoprotein (LDL) cholesterol levels with cognitive decline.Design, setting, and participantsIndividual participant data meta-analysis of 4 US cohort studies (conducted 1971-2019). Linear mixed-effects models estimated changes in cognition after incident stroke. Median (IQR) follow-up was 4.7 (2.6-7.9) years. Analysis began August 2021 and was completed March 2023.ExposuresTime-dependent cumulative mean poststroke SBP, glucose, and LDL cholesterol levels.Main outcomes and measuresThe primary outcome was change in global cognition. Secondary outcomes were change in executive function and memory. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1-SD difference in cognition.ResultsA total of 1120 eligible dementia-free individuals with incident stroke were identified; 982 (87.7%) had available covariate data and 138 (12.3%) were excluded for missing covariate data. Of the 982, 480 (48.9%) were female individuals, and 289 (29.4%) were Black individuals. The median age at incident stroke was 74.6 (IQR, 69.1-79.8; range, 44.1-96.4) years. Cumulative mean poststroke SBP and LDL cholesterol levels were not associated with any cognitive outcome. However, after accounting for cumulative mean poststroke SBP and LDL cholesterol levels, higher cumulative mean poststroke glucose level was associated with faster decline in global cognition (-0.04 points/y faster per each 10-mg/dL increase [95% CI, -0.08 to -0.001 points/y]; P = .046) but not executive function or memory. After restricting to 798 participants with apolipoprotein E4 (APOE4) data and controlling for APOE4 and APOE4 × time, higher cumulative mean poststroke glucose level was associated with a faster decline in global cognition in models without and with adjustment for cumulative mean poststroke SBP and LDL cholesterol levels (-0.05 points/y faster per 10-mg/dL increase [95% CI, -0.09 to -0.01 points/y]; P = .01; -0.07 points/y faster per 10-mg/dL increase [95% CI, -0.11 to -0.03 points/y]; P = .002) but not executive function or memory declines.Conclusions and relevanceIn this cohort study, higher poststroke glucose levels were associated with faster global cognitive decline. We found no evidence that poststroke LDL cholesterol and SBP levels were associated with cognitive decline.

Project description:Background and aimPrevious studies on cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) and cognitive trajectories mainly focus on Western populations and most of them have used a single measure of cardiovascular risk. In this study, among middle-aged and older Chinese, we investigated (i) the association of baseline FGCRS with subsequent cognitive decline and (ii) the association of FGCRS change with concomitant cognitive decline.Materials and methodsIn wave 1 to wave 4 (2011-2018) of the China Health and Retirement Longitudinal Study, global cognition was assessed by orientation, memory, and executive function. FGCRS was assessed and categorized into tertiles (low, intermediate, and high) at baseline (2011) and 4 years after (2015). Furthermore, external validation was performed to check its generalizability using the English Longitudinal Study of Ageing (ELSA) 2008-2018.ResultsIn total, 6,402 participants with a mean [standard deviation (SD) age of 57.8 (8.4) years, 49.0% women] with complete baseline data and at least one reassessment of cognitive function were included. A 10% increment in baseline FGCRS was associated with a faster decline in global cognition (-0.010 SD/year, 95% CI -0.013, -0.008). Among 4,336 participants [mean (SD) age of 57.8 (8.2) years, 50.0% women] with data on FGCRS changes, compared to individuals with the consistently low FGCRS (reference group), a faster global cognition decline rate was observed in the low to intermediate group (-0.026 SD/year, 95% CI -0.045, -0.007), the low to high group (-0.052 SD/year, 95% CI -0.102, -0.001), the consistently intermediate group (-0.019 SD/year, 95% CI -0.033, -0.005), the intermediate to high group (-0.040 SD/year, 95% CI -0.058, -0.022), the high to intermediate group (-0.024 SD/year, 95% CI -0.047, -0.002), and the consistently high group (-0.047 SD/year, 95% CI -0.060, -0.034). Similar trends were observed for individual cognitive domains. Results from the external validation using the ELSA remained consistent.ConclusionHigher baseline FGCRS was associated with faster cognitive decline. However, there was no consistent relationship between the direction of changes in FGCRS and cognitive decline.

Dataset Information

Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline.

Background

Objectives

Methods

Results

Conclusions

Publications

Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline.

Similar Datasets

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