Cardiovascular Risk Associated with Poorer Memory in Middle-Aged Adults from the Healthy Brain Project

Midlife cardiovascular risk factors (CVRF) are associated with reduced cognition and an increased risk of dementia.

To further investigate this association using remote unsupervised online assessment of cognition and cardiovascular risk in middle-aged adults; and to explore the extent to which the association is altered by carriage of the APOE ɛ4 allele.

The Healthy Brain Project is an online cohort of middle-aged cognitively unimpaired adults (40-70 years) who have undergone cognitive assessment and provided self-reports of demographic and health history. Cardiovascular risk was determined by ascertaining history of hypertension, hypercholesterolemia, diabetes mellitus, overweight (body mass index≥25), and current cigarette smoking. Participants (n = 2,480) were then grouped based on the number of reported CVRF into no CVRF, 1, 2, and≥3 CVRF. Associations between the number of CVRF as a continuous variable, CVRF group, and each individual CVRF with composite measures of attention, memory and subjective cognitive function were investigated.

Higher number of CVRF was associated with poorer attention (β= -0.042, p = 0.039) and memory (β= -0.080, p < 0.001), but not with subjective cognitive function. When considered individually, current smoking (β= -0.400, p = 0.015), diabetes (β= -0.251, p = 0.023), and hypercholesterolemia (β= -0.109, p = 0.044) were independently associated with poorer memory performance. APOE ɛ4 carriers with≥1 CVRF performed worse on memory than ɛ4 carriers with no CVRFs (β(SE) = 0.259(0.077), p = 0.004). This was not observed in ɛ4 non-carriers.

In cognitively normal middle-aged adults, CVRF were associated with poorer cognition, particularly in the memory domain. These results support feasibility of online assessment of cardiovascular risk for cognitive impairment.