Baseline cognition and demographic, lifestyle, and cardiovascular risk factors in US POINTER

Validation of the primary cognitive composite and baseline cognitive characteristics are presented for the US-Study-to-Protect-Brain-Health-Through-Lifestyle-Intervention-to-Reduce-Risk (US POINTER).

US POINTER is a multicenter, randomized clinical trial of two lifestyle interventions testing cognitive benefit in older adults without significant cognitive impairment but at-risk for decline due to well-established factors. Cognition is measured using a global cognitive composite (US POINTER modified Neuropsychological Test Battery-PmNTB).

The PmNTB is a valid cognitive composite, exhibiting good psychometric properties and tracking with other established outcomes. Among the 2111 enrolled participants (mean age = 68.2 years, 69% women, 31% from race and ethnic minoritized groups), demographic characteristics alone (age, sex, education, race, ethnicity) explained more variance in cognition measured using the PmNTB (25.94%) compared with cardiovascular and family history risk factors combined (added < 3% explained variance).

In a large diverse older adult cohort, demographic features rather than well-established risks for cognitive decline correlate with baseline global cognition.

NCT03688126 HIGHLIGHTS: Demographic characteristics explain baseline cognition in at-risk older adults. The POINTER Modified Neuropsychological Test Battery (PmNTB) is a valid measure. Worse cognition tracks with E4+, high HbA1c, current smoking, Framingham heart risk.