Association of Vascular Risk Scores and Cognitive Performance in a Diverse Cohort: The Multi-Ethnic Study of Atherosclerosis

Christopher L Schaich; Joseph Yeboah; Mark A Espeland; Laura D Baker; Jingzhong Ding; Kathleen M Hayden; Bonnie C Sachs; Suzanne Craft; Stephen R Rapp; José A Luchsinger; Annette L Fitzpatrick; Susan R Heckbert; Wendy S Post; Gregory L Burke; Norrina B Allen; Timothy M Hughes

doi:10.1093/gerona/glab189

Association of Vascular Risk Scores and Cognitive Performance in a Diverse Cohort: The Multi-Ethnic Study of Atherosclerosis

J Gerontol A Biol Sci Med Sci. 2022 Jun 1;77(6):1208-1215. doi: 10.1093/gerona/glab189.

Authors

Christopher L Schaich¹, Joseph Yeboah², Mark A Espeland³, Laura D Baker⁴, Jingzhong Ding⁴, Kathleen M Hayden⁵, Bonnie C Sachs^{4

6}, Suzanne Craft⁴, Stephen R Rapp⁷, José A Luchsinger^{8

9}, Annette L Fitzpatrick^{10

11

12}, Susan R Heckbert¹⁰, Wendy S Post¹³, Gregory L Burke¹⁴, Norrina B Allen¹⁵, Timothy M Hughes⁴

Affiliations

¹ Department of Surgery/Hypertension, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
² Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
³ Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁴ Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁵ Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁶ Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁷ Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁸ Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
⁹ Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA.
¹⁰ Department of Epidemiology, University of Washington, Seattle, USA.
¹¹ Department of Family Medicine, University of Washington, Seattle, USA.
¹² Department of Global Health, University of Washington, Seattle, USA.
¹³ Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹⁴ Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
¹⁵ Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Abstract

Background: Vascular risk scores are associated with incident dementia. Information regarding their association with cognitive performance and decline in racially/ethnically diverse cohorts is lacking.

Method: In 4 392 Multi-Ethnic Study of Atherosclerosis participants (aged 60.1 ± 9.4 years; 53% women; 41% White, 11% Chinese American, 26% African American, 21% Hispanic), we compared associations of Exam 1 (2000-2002) Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE), Framingham Stroke Risk Profile (FSRP), and atherosclerotic cardiovascular disease pooled cohort equation (ASCVD-PCE) risk scores with Exam 5 (2010-2012) Cognitive Abilities Screening Instrument (CASI), Digit Symbol Coding (DSC), and Digit Span (DS) cognitive test performance using multivariable linear regression, and examined racial/ethnic interactions. In 1 838 participants with repeat CASI data at Exam 6 (2016-2018), we related risk scores to odds of a 1-SD decline in CASI performance using multivariable logistic regression.

Results: SD increments in each risk score were associated with worse cognitive performance. CAIDE had stronger associations with CASI performance than the FSRP and ASCVD-PCE, but associations of ASCVD-PCE with the DSC and DS were similar to CAIDE (difference in β [95% CI] = -0.57 [-1.48, 0.34] and -0.21 [-0.43, 0.01], respectively). Race/ethnicity modified associations. For example, associations between CAIDE and CASI were greater in African Americans and Hispanics than in Whites (difference in β = 0.69 [0.02, 1.36] and 1.67 [0.95, 2.39], respectively). Risk scores were comparably associated with decline in CASI performance.

Conclusions: Antecedent vascular risk scores are associated with cognitive performance and decline in the 4 most common U.S. racial/ethnic groups, but associations differ among risk scores and by race/ethnicity.

Keywords: Cardiovascular; Cognition; Cognitive aging; Race/ethnicity; Risk factors.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Atherosclerosis* / epidemiology
Cognition
Dementia*
Ethnicity
Female
Humans
Male
Risk Factors

Abstract

Publication types

MeSH terms

Grants and funding