Cardiovascular Risk and Cognitive Function in Middle-Aged and Older Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Article type: Research Article

Authors: Tarraf, Wassim^{a; *} | Kaplan, Robert^b | Daviglus, Martha^c | Gallo, Linda C.^d | Schneiderman, Neil^e | Penedo, Frank J.^f | Perreira, Krista M.^g | Lamar, Melissa^{c; h} | Chai, Albertⁱ | Vásquez, Priscilla M.ⁱ | González, Hector M.^{i; *}

Affiliations: [a] Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA | [b] Albert Einstein College of Medicine, Bronx, NY, USA | [c] Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA | [d] Department of Psychology, San Diego State University, San Diego, CA, USA | [e] Department of Psychology, University of Miami, Miami, FL, USA | [f] Feinberg School of Medicine, Northwestern University, Chicago, IL, USA | [g] School of Medicine, University of North Carolina, Chapel Hill, NC, USA | [h] Department of Psychiatry & Behavioral Sciences and Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA | [i] Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, UC San Diego, La Jolla, CA, USA

Correspondence: [*] Correspondence to: Wassim Tarraf, Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, Michigan 259 Mack Avenue, Detroit, MI 48201, USA. E-mail: [email protected]; and Hector M. González, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, USA. E-mail: [email protected].

Abstract: Background:Cardiovascular disease is linked to cognitive decline and disorders (e.g., dementia). The evidence is based largely on older non-Latino White cohorts. Objective:Examine the association between global vascular risk and cognitive function among Hispanics/Latinos in the United States. Methods:We used data from a large sample of stroke- and cardiovascular disease-free, middle-aged and older Hispanics/Latinos with diverse backgrounds (n=7,650) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We compared associations between two measures of cardiovascular risk (CVR), the Framingham Cardiovascular Risk Score (FCRS) and the multiethnic Global Vascular Risk Score (GVRS), and cognitive performance using measures of global and domain specific cognitive function, and tested for modification by sex and age. Results:Higher FCRS and GVRS were associated with lower global cognition and higher probability of low mental status, after covariates adjustment. Both CVR indices were associated with lower performances in learning and memory, verbal fluency, and psychomotor speed. Higher GVRS presented stronger associations with lower cognitive function compared to the FCRS. Women and younger age (45–64 years) exhibited more pronounced associations between higher CVR and worse cognition, particularly so with the GVRS. Discussion:CVR is also a risk for compromised cognitive function and evident in middle-age among Hispanics/Latinos. The multiethnic GVRS, tailored to specific risks based on racial/ethnic background, is feasible to use in primary care settings and can provide important insight on cognitive risk. Even modest shifts in population toward cardiovascular health in the high-risk Hispanic/Latino population can have important positive impacts on healthy cognitive aging.

Keywords: Cardiovascular risk, cognition, HCHS/SOL, Hispanics/Latinos, neuroepidemiology, neuropsychology

DOI: 10.3233/JAD-190830

Journal: Journal of Alzheimer's Disease, vol. 73, no. 1, pp. 103-116, 2020