Cardiovascular risk burden tied to neurodegeneration, cognitive decline

Higher cardiovascular risk burden correlates with neurodegeneration and vascular lesions in the brain and appears to be a predictor of decline in episodic memory, working memory, and perceptual speed, a study has shown.

A total of 1,588 dementia-free participants (mean age, 79.5 years) within the Rush Memory and Aging Project were followed for up to 21 years. The authors evaluated the Framingham General Cardiovascular Risk Score (FGCRS) at baseline and categorized FGCRS into tertiles (lowest, middle, and highest). They also assessed episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed annually with a battery of 19 tests, from which composite scores were derived.

A subsample of 378 participants underwent magnetic resonance imaging (MRI). Structural total and regional brain volumes were estimated. Linear mixed-effects models and linear regression models were used to analyse data.

FGCRS ranged from 4 to 28 (mean score, 15.6±3.7) in all participants. The highest tertile correlated with faster decline in global cognition (β, –0.019, 95 percent confidence interval [CI], −0.035 to −0.003), episodic memory (β, −0.023, 95 percent CI, −0.041 to −0.004), working memory (β, −0.021, 95 percent CI, −0.035 to −0.007), and perceptual speed (β, −0.027, 95 percent CI, −0.042 to −0.011) compared to the lowest tertile over the follow-up.

MRI data analyses revealed that higher FGCRS was associated with smaller volumes of the hippocampus (β, −0.021, 95 percent CI, −0.042 to −0.000), gray matter (β, −1.569, 95 percent CI, −2.757 to −0.382), and total brain (β, −1.588; 95 percent CI, −2.832 to −0.344), and greater volume of white matter hyperintensities (β, 0.035, 95 percent CI, 0.001–0.069).