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Association of cerebrovascular risk burden with mild cognitive impairment, dementia and brain vascular pathologies
Author(s) -
Song Ruixue,
Xu Hui,
Pan KuanYu,
Qi Xiuying,
Buchman Aron S,
Bennett David A,
Xu Weili
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.040528
Subject(s) - dementia , medicine , framingham heart study , hazard ratio , vascular dementia , logistic regression , incidence (geometry) , odds ratio , framingham risk score , proportional hazards model , cardiology , confidence interval , disease , physics , optics
Background To examine the association of cardiovascular risk burden assessed by Framingham General Cardiovascular Risk Score (FGCRS) with incidence of mild cognitive impairment (MCI) and dementia, and brain vascular pathologies. Methods Within the Rush Memory and Aging Project, 1203 cognitively intact participants were identified at baseline and followed up to 21 years to detect incident MCI and dementia. FGCRS was assessed at baseline and categorized into tertiles (the lowest, middle, and the highest). MCI and dementia were diagnosed following standard criteria. During the follow‐up, 423 participants died and underwent autopsies for neuropathological assessments. Data were analyzed using Cox regression model, linear regression and logistic regression. Results During the follow‐up, 457 participants developed MCI and 192 developed dementia. FGCRS, as continuous variable, was dose‐dependently related to the incidence of MCI and dementia. Compared to the participants with the lowest tertile of FGCRS, those with the highest tertile had the multi‐adjusted hazard ratio (HR) of 1.34 (95% CI 1.04‐1.73) for MCI and 1.49 (95% CI 1.01‐2.21) for dementia. Further, FGCRS was dose‐dependently associated with gross chronic cerebral infarctions (odds ratio [OR] 1.08, 95% CI 1.01‐1.15) and cerebral atherosclerosis (OR 1.09, 95% CI 1.00‐1.18), but not with other brain pathologies. Conclusion Higher cardiovascular risk burden is associated with an increased risk of MCI and dementia. Cerebral infarctions and atherosclerosis might underlie this association.