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Multimodal Associations of Modifiable Risk Factors on White Matter Injury: The SOL-INCA-MRI Study (HCHS/SOL).

Shraddha Sapkota¹, Pauline Maillard¹, Ariana M Stickel²

¹Department of Neurology, University of California, Davis (S.S., P.M., C.D.).

|March 24, 2025

Summary

Lifestyle factors like diet and exercise significantly impact brain health, reducing dementia risk. Addressing these modifiable risks together offers a promising path to prevent white matter injury and cognitive decline in at-risk populations.

Keywords:

Hispanic or Latino aging brain cardiovascular diseases white matter

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Area of Science:

Neuroscience
Public Health
Gerontology

Background:

Modifiable risk factors are crucial in neurodegenerative disorders and dementias.
Previous research focused on independent risk factor associations, not simultaneous impacts.
White matter injury is a key risk factor for dementia.

Purpose of the Study:

To examine independent associations of 5 modifiable risk factors with white matter injury.
To investigate the combined impact of these factors in a multimodal model.
To analyze these associations in a diverse Hispanic/Latino population.

Main Methods:

Utilized data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) longitudinal study (n=2667).
Conducted path and mediation analyses on 5 modifiable risk factors and white matter injury measures (free water, white matter hyperintensity volume).
Controlled for age, sex, education, heritage, cognitive status, and b-value.

Main Results:

Identified 11 significant independent associations between risk factors and white matter injury.
Found mediation pathways: cardiovascular risk score to white matter hyperintensity via free water, and physical activity to body mass index via sleep duration.
Developed an overall model incorporating diet and physical activity associations.

Conclusions:

Modifiable risk factors synergistically influence future white matter injury in Hispanic/Latino populations.
Multimodal models can inform personalized lifestyle interventions for dementia prevention.
Targeting combined lifestyle factors may reduce white matter injury and dementia risk.