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. 2022 Jun 1;77(6):1208-1215.
doi: 10.1093/gerona/glab189.

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

Christopher L Schaich  1 , Joseph Yeboah  2 , Mark A Espeland  3 , Laura D Baker  4 , Jingzhong Ding  4 , Kathleen M Hayden  5 , Bonnie C Sachs  4   6 , Suzanne Craft  4 , Stephen R Rapp  7 , José A Luchsinger  8   9 , Annette L Fitzpatrick  10   11   12 , Susan R Heckbert  10 , Wendy S Post  13 , Gregory L Burke  14 , Norrina B Allen  15 , Timothy M Hughes  4
Affiliations

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

Christopher L Schaich et al. J Gerontol A Biol Sci Med Sci. .

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.

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Figures

Figure 1.
Figure 1.
Exam 1 (2000–2002) risk scores by race/ethnicity. Error bars represent 95% confidence intervals. *p < .05 vs White.
See this image and copyright information in PMC

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