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Cardiovascular Health and Biomarkers of Neurodegenerative Disease in Older Adults
Anisa Dhana1,2, Charles S DeCarli3, Klodian Dhana1,2
1Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois.
Insights
Improving cardiovascular health (CVH) in older adults is linked to lower neurofilament light chain (NfL) levels, a biomarker for neurodegeneration. This suggests CVH may reduce the risk of neurodegenerative diseases, especially in Black adults.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Cardiovascular health (CVH), defined by Life's Simple 7, is crucial for managing vascular risk factors.
- While associated with reduced dementia risk, its link to neurodegeneration biomarkers is less understood.
Purpose of the Study:
- To investigate the association between CVH and serum biomarkers of neurodegeneration, specifically neurofilament light chain (NfL) and total tau (t-tau).
Main Methods:
- A cohort study of adults aged 65+ from the Chicago Health and Aging Project (CHAP) (1993-2012).
- CVH score assessed based on diet, exercise, BMI, smoking, dyslipidemia, diabetes, and hypertension.
- Linear regression and mixed-effects models analyzed the association between CVH score and serum NfL and t-tau levels.
Main Results:
- Higher CVH scores (10-14 points) were associated with significantly lower serum NfL levels (-18.9%) compared to low CVH scores (0-6 points).
- Increased CVH was linked to a slower annual increase in NfL levels over time.
- No significant association was found between CVH and serum t-tau levels.
Conclusions:
- Promoting cardiovascular health in older adults may help mitigate neurodegenerative disease burden.
- Findings are particularly relevant for Black adults, who have a higher prevalence of cardiovascular disease and may benefit from improved CVH.
Importance:
Cardiovascular health (CVH), defined by the American Heart Association as Life's Simple 7 to promote a healthy lifestyle and manage vascular risk factors, has been associated with a low risk of Alzheimer disease and less vascular dementia. However, the association between CVH and biomarkers of neurodegeneration remains less understood.
Objective:
To investigate the association of CVH with serum biomarkers of neurodegeneration, including neurofilament light chain (NfL) and total tau (t-tau).
Design, Setting, And Participants:
This cohort study was conducted within the biracial, population-based Chicago Health and Aging Project (CHAP) of adults aged 65 years or older between 1993 and 2012. Participants who had measured serum NfL and t-tau levels and data on all components of the CVH score were included. The statistical analysis was conducted from April 10 to September 26, 2024.
Exposure:
The CVH score includes 7 components: a healthy diet; regular exercise; normal body mass index; nonsmoking status; and the absence of dyslipidemia, diabetes, and hypertension. The scores were divided into 3 groups from lowest to highest CVH (0-6 points, 7-9 points, and 10-14 points).
Main Outcomes And Measures:
The main outcome was the association of CVH score with serum biomarkers of NfL and t-tau as measured using linear regression and mixed-effects models.
Results:
A total of 1018 CHAP participants were included in the analysis (mean [SD] age, 73.1 [6.1] years; 625 female [61.4%]; 610 Black or African American [59.9%] and 408 White [40.1%]). Participants with a high CVH score (ie, 10-14 points) were predominantly White (151 [64.3%]) and had a higher education (mean [SD], 13.6 [3.7] years). Compared with participants with low CVH scores (ie, 0-6 points), those with CVH scores of 10 to 14 points had significantly lower serum levels of NfL (relative difference, -18.9%; β = -0.091; SE, 0.025). A higher CVH score was associated with a slower annual increase in NfL levels as participants aged (relative difference in rate, -1.7%; β = -0.008; SE, 0.004). Cardiovascular health was not associated with serum levels of t-tau.
Conclusions And Relevance:
These findings suggest that promoting CVH in older adults may help alleviate the burden of neurodegenerative diseases, particularly among Black adults, who are known to experience a higher prevalence of cardiovascular disease.
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