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Coronary artery calcium: associations with brain magnetic resonance imaging abnormalities and cognitive status
Caterina Rosano1, Barbara Naydeck, Lewis H Kuller
1Department of Epidemiology, School of Public Health, University of Pittsburgh, 130 N. Bellefield Avenue, Pittsburgh, PA 15260, USA. RosanoC@edc.pitt.edu
Insights
High coronary artery calcification (CAC) in older adults is linked to more severe brain MRI abnormalities and cognitive decline. This highlights the connection between heart health and brain health in aging populations.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Gerontology
Background:
- Coronary atherosclerosis, indicated by coronary artery calcification (CAC), is a significant health concern in older adults.
- Subclinical brain magnetic resonance imaging (MRI) abnormalities and cognitive impairment are prevalent in aging populations.
- The relationship between systemic atherosclerosis and brain health requires further investigation.
Purpose of the Study:
- To investigate the association between coronary atherosclerosis and subclinical brain MRI abnormalities.
- To examine the link between coronary atherosclerosis and abnormal cognitive function, including dementia and mild cognitive impairment.
Main Methods:
- A cross-sectional study involving 409 older adults (mean age 79) from the Cardiovascular Health Study (CHS).
- Coronary artery calcification (CAC) measured using electronic beam tomography.
- Brain MRI assessed for ventricular enlargement, white matter hyperintensities, and subcortical brain infarcts; cognitive status evaluated. Multivariate logistic regression analyzed associations.
Main Results:
- Higher CAC scores were significantly associated with more severe brain MRI abnormalities, specifically subcortical infarction and white matter hyperintensities.
- A trend suggested an association between CAC and ventricular enlargement, though not statistically significant.
- The presence of any brain MRI abnormality diminished the association between CAC and abnormal cognitive status.
Conclusions:
- Elevated CAC levels in older adults correlate with increased severity of subclinical brain MRI abnormalities.
- Higher CAC is associated with a greater likelihood of abnormal cognitive status in older individuals.
- Findings underscore the interconnectedness of cardiovascular health and brain integrity in aging.
Objectives:
To evaluate the association between coronary atherosclerosis and subclinical brain magnetic resonance imaging (MRI) abnormalities and between coronary atherosclerosis and abnormal cognitive function (dementia/mild cognitive impairment).
Design:
Cross-sectional.
Setting:
The Cardiovascular Health Study (CHS), an epidemiological study of risk factors for cardiovascular disease in older adults.
Participants:
Four hundred nine men and women, mean age 79, recruited from the Pittsburgh center of the CHS.
Measurements:
Coronary atherosclerosis was defined according to the level of coronary artery calcification (CAC), as measured using electronic beam tomography. Subclinical brain MRI abnormalities included ventricular enlargement, white matter hyperintensities, and number of subcortical brain infarcts. Brain MRI and CAC measurements were performed between 1998 and 2000 at the Pittsburgh center of the CHS. Prevalence of brain MRI abnormalities and abnormal cognitive status were examined across quartiles of the CAC score, before and after controlling for age. Multivariate logistic regression models were used to assess whether CAC level was associated with abnormalities of brain MRI or abnormal cognitive status.
Results:
Older adults with high CAC scores were more likely to have more-severe brain MRI abnormalities, including subcortical infarction and high white matter hyperintensities. The associations between CAC and ventricular enlargement showed a similar but not significant trend. The presence of any of the MRI abnormalities attenuated the association between CAC and abnormal cognitive status.
Conclusion:
Older adults with higher levels of CAC were more likely to have more-severe brain MRI abnormalities and abnormal cognitive status.
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