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Visit-to-visit variability in multiple biological measurements and cognitive performance and risk of cardiovascular

Laura Sherlock1,2, Shun Fu Lee2, Tali Cukierman-Yaffe3,4

  • 1Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.

Cerebral Circulation - Cognition and Behavior
|May 27, 2024
PubMed

Insights

Visit-to-visit variability in blood pressure, heart rate, weight, and glucose is linked to worse cognitive function and increased cardiovascular disease (CVD) risk. Multiple biological measures with high variability showed additive negative effects on cognition and CVD outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Metabolic Health

Background:

  • Visit-to-visit variability in single biological markers is linked to cognitive decline and cardiovascular disease (CVD).
  • The impact of variability across multiple biological measures on health outcomes remains underexplored.
  • This study examines the association between visit-to-visit variability in key physiological parameters and cognitive/cardiovascular health.

Purpose of the Study:

  • To investigate the effect of visit-to-visit variability in blood pressure (BP), heart rate (HR), weight, fasting plasma glucose (FPG), cholesterol, and triglycerides on cognitive performance.
  • To assess the association between visit-to-visit variability in these biological measures and the risk of cardiovascular events.
  • To determine if the effects of high variability in multiple measures are cumulative.

Main Methods:

  • Utilized data from the ORIGIN trial, analyzing BP, HR, weight, glucose, cholesterol, and triglycerides.
  • Calculated visit-to-visit standard deviation for each participant and measurement to quantify variability.
  • Classified participants based on the number of measurements with high variability (highest quartile) and used regression/survival models for analysis.

Main Results:

  • Increased visit-to-visit variability in BP, HR, weight, and FPG was significantly associated with poorer cognitive scores (Mini Mental State Examination - MMSE) and higher CVD risk.
  • The effects of high variability were additive; individuals with ≥4 highly variable measures showed significantly poorer MMSE scores and a substantially higher risk of CVD compared to those with no high variability.
  • Effect sizes for individual measurements were comparable.

Conclusions:

  • Visit-to-visit variability in multiple biological measurements is cumulatively associated with poorer cognitive performance.
  • Elevated visit-to-visit variability across several physiological parameters significantly increases the risk of cardiovascular events.
  • Managing variability in biological markers may be crucial for improving cognitive and cardiovascular health outcomes.
Abstract

Keywords:
Cardiovascular diseaseCognitionMIStrokeVisit-to-visit variability

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