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

Ruixue Song1, Hui Xu1, Christina S Dintica2

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Journal of the American College of Cardiology
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Higher cardiovascular risk burden, measured by the Framingham General Cardiovascular Risk Score (FGCRS), is linked to faster cognitive decline and brain structure changes, including reduced brain volume and increased white matter hyperintensities.

Keywords:
Framingham General Cardiovascular Risk Scorecognitive declinecohort studymagnetic resonance imagingneurodegenerationvascular lesions

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Area of Science:

  • Neuroscience
  • Cardiology
  • Gerontology

Background:

  • The relationship between cardiovascular risk and cognitive trajectories is not fully understood.
  • Cardiovascular risk burden may impact brain structure and cognitive function over time.

Purpose of the Study:

  • To investigate the association between cardiovascular risk burden, assessed by the Framingham General Cardiovascular Risk Score (FGCRS), and cognitive decline.
  • To examine the link between FGCRS and structural brain differences, including brain volumes and white matter hyperintensities.

Main Methods:

  • Longitudinal study of 1,588 dementia-free older adults (mean age 79.5 years) over 21 years.
  • Assessment of FGCRS at baseline, categorized into tertiles.
  • Annual cognitive assessments (episodic memory, semantic memory, working memory, visuospatial ability, perceptual speed) and MRI scans in a subsample (n=378) for brain structure analysis.

Main Results:

  • Participants in the highest FGCRS tertile showed significantly faster decline in global cognition, episodic memory, working memory, and perceptual speed compared to the lowest tertile.
  • Higher FGCRS was associated with reduced volumes of the hippocampus, gray matter, and total brain.
  • Elevated FGCRS correlated with a greater volume of white matter hyperintensities, indicating cerebrovascular damage.

Conclusions:

  • Elevated cardiovascular risk burden is a significant predictor of cognitive decline in multiple domains, including memory and processing speed.
  • Higher cardiovascular risk is associated with neurodegenerative changes and cerebrovascular lesions in the aging brain.
  • These findings highlight the importance of managing cardiovascular risk factors to preserve cognitive function and brain health in older adults.