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Cardiovascular and stroke risk, cognitive change, and mild cognitive impairment: Results from the HCHS/SOL and SOL‐INCA
Author(s) -
Tarraf Wassim,
Wu Benson,
Ramos Alberto R,
Gallo Linda,
Stickel Ariana,
Gonzalez Hector M,
Vasquez Priscilla M,
Daviglus Martha,
Zeng Donglin,
Schneiderman Neil,
Lipton Richard B,
Isasi Carmen R,
Lamar Melissa,
Smoller Sylvia,
Cai Jianwen
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.044166
Subject(s) - cognition , cardiovascular health , cognitive decline , verbal fluency test , medicine , stroke (engine) , gerontology , health and retirement study , dementia , disease , psychomotor learning , clinical psychology , psychology , neuropsychology , psychiatry , mechanical engineering , engineering
Background Cardiovascular and cerebrovascular health problems significantly increase risk for Alzheimer’s Disease and Related Dementias (ADRDs), and Hispanics/Latinos are arguably at higher risk for ADRDs compared to Whites. Middle‐age may be a crucial time in which cardiovascular health starts to notably impact cognition. Most research supporting connections between cardiovascular and cognitive health and ADRDs has been conducted with non‐Hispanic/Latino White samples. Diverse Hispanics/Latinos may differentially benefit from improvements in cardiovascular health to an equal or greater extent than Whites. The purpose of the study was to characterize the associations between mid‐life cardiovascular health and 7‐year change in cognition in diverse Hispanics/Latinos. Methods We used prospective data from middle‐age and older Latinos (45‐74 years and older at Visit1; 2008‐2011) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Visit 1) who were cardiovascular disease‐free and stroke/TIA‐free at Visit1 (unweighted n=3,345) to examine relationships between baseline cardiovascular health, assessed using the multiethnic Global Vascular Risk Score (GVRS), and change in cognition from Visit1 to Visit2 (SOL‐INCA; 2016‐2018), an average of 7‐years later, and Mild Cognitive Impairment (MCI) prevalence at Visit2. In addition to MCI, cognitive outcomes included global and domain specific (verbal learning and memory, verbal fluency, executive functioning, attention, and psychomotor speed tasks) cognitive change. We fit survey generalized linear regressions to model the associations between the cardiovascular risk exposure and our cognitive outcomes and examined modifications by sex and age. Results Adjusting for covariates, higher GVRS scores (10% increments) were associated with more pronounced decline (SD units) in global (β=‐0.35; SE=0.06; p<0.001) and domain specific cognitive performance. Higher GVRS scores were also associated with higher odds ratio of MCI (OR=1.59; 95% CI=[1.10;2.38]; p=0.023) at Visit 2. We found no statistical evidence to support sex or age modifications in the associations between GVRS, cognitive change, and MCI. Conclusion Cardiovascular and stroke risk is associated with accelerated cognitive decline and an increased risk of MCI. Effects did not differ by age. These results raise the possibility that vascular risk factor modification in Hispanics/Latinos may promote successful cognitive aging and reduce the risk for MCI.