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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Aspirin moderates the association between cardiovascular risk, brain white matter hyperintensity total lesion volume
Mina Khezrian1, Jennifer M J Waymont1, Phyo K Myint2
1Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
Insights
Low-dose aspirin use moderates the negative impact of white matter hyperintensity (WMH) burden on cognitive function in older adults. Aspirin users showed a stronger link between WMH and cognition than non-users.
Area of Science:
- Neurology
- Gerontology
- Cardiovascular Medicine
Background:
- Cardiovascular risk is linked to cognitive decline via brain pathology like white matter hyperintensity (WMH).
- Low-dose aspirin is commonly used to prevent vascular events.
Purpose of the Study:
- To investigate how aspirin use affects the relationship between cardiovascular risk, WMH burden, and cognitive function.
- To determine if aspirin use modifies the impact of WMH on cognition.
Main Methods:
- Study included 318 dementia-free adults (aged 67-71), with 239 undergoing brain MRI.
- White matter hyperintensity total lesion volumes (TLV) were quantified using automated segmentation.
- Cardiovascular risk was assessed using the ASSIGN score, and cognitive ability by processing speed tests.
Main Results:
- Sixty-eight participants (47.1% male, mean age 68.8) reported aspirin use.
- Aspirin users showed a significant negative association between WMH TLV and cognition (β = -0.43, p < 0.001).
- In non-users, only cardiovascular risk predicted poorer cognition (β = -0.17, p = 0.001).
Conclusions:
- Aspirin use moderates the detrimental effect of WMH burden on cognitive function.
- Incorporating WMH burden alongside cardiovascular risk may enhance cognitive decline prediction in older aspirin users.
Objectives:
Cardiovascular risk is associated with cognitive decline and this effect is attributed to brain pathology, including white matter hyperintensity (WMH) burden. Low-dose aspirin is frequently recommended for reducing vascular events. We investigated the effect of taking aspirin on the association between cardiovascular risk, WMH burden and cognitive function.
Study Design:
The study sample was drawn from 318 dementia-free adults aged 67-71 years. Brain magnetic resonance imaging (MRI) scans were acquired from 239 participants.
Main Outcome Measures:
WMH total lesion volumes (TLV) were extracted using the automated lesion segmentation algorithm. We measured cardiovascular risk by calculating ASSIGN score. Cognitive ability was measured using a test of processing speed. We developed structural equation models to test our hypothesis.
Results:
Sixty-eight participants (47.1 % male, mean age = 68.8 years) reported that they took aspirin. The demographic measures did not differ significantly by aspirin use. Among aspirin users, there was a strong negative association between WMH TLV and cognition (β = -0.43, p-value < 0.001), while in non-users of aspirin the only significant predictor of poorer cognition was cardiovascular risk (β = -0.17, p-value = 0.001).
Conclusions:
Aspirin use moderates the negative effect of WMH burden on cognition. Considering WMH burden in addition to cardiovascular risk could improve the prediction of cognitive decline in older adults with aspirin use.
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