Cardiovascular Risk Associated with Poorer Memory in Middle-Aged Adults from the Healthy Brain Project

Article type: Research Article

Authors: Yassi, Nawaf^{a; b; *} | Pase, Matthew P.^{c; d} | Buckley, Rachel F.^{c; e; f; g} | Rosenich, Emily^c | Watson, Rosie^{b; h} | Maruff, Paul^{c; i} | Lim, Yen Ying^c

Affiliations: [a] Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia | [b] Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia | [c] The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia | [d] Harvard T.H. Chan School of Public Health, Boston, MA, USA | [e] Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia | [f] Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA | [g] Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA | [h] Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia | [i] Cogstate Ltd., Melbourne, VIC, Australia

Correspondence: [*] Correspondence to: A/Prof Nawaf Yassi, Department of Neurology, The Royal Melbourne Hospital, Grattan St, Parkville, Victoria 3050, Australia. Tel.: +613 9342 7000; E-mail: [email protected].

Abstract: Background:Midlife cardiovascular risk factors (CVRF) are associated with reduced cognition and an increased risk of dementia. Objective:To further investigate this association using remote unsupervised online assessment of cognition and cardiovascular risk in middle-aged adults; and to explore the extent to which the association is altered by carriage of the APOE ɛ4 allele. Methods:The Healthy Brain Project is an online cohort of middle-aged cognitively unimpaired adults (40–70 years) who have undergone cognitive assessment and provided self-reports of demographic and health history. Cardiovascular risk was determined by ascertaining history of hypertension, hypercholesterolemia, diabetes mellitus, overweight (body mass index≥25), and current cigarette smoking. Participants (n = 2,480) were then grouped based on the number of reported CVRF into no CVRF, 1, 2, and≥3 CVRF. Associations between the number of CVRF as a continuous variable, CVRF group, and each individual CVRF with composite measures of attention, memory and subjective cognitive function were investigated. Results:Higher number of CVRF was associated with poorer attention (β= –0.042, p = 0.039) and memory (β= –0.080, p < 0.001), but not with subjective cognitive function. When considered individually, current smoking (β= –0.400, p = 0.015), diabetes (β= –0.251, p = 0.023), and hypercholesterolemia (β= –0.109, p = 0.044) were independently associated with poorer memory performance. APOE ɛ4 carriers with≥1 CVRF performed worse on memory than ɛ4 carriers with no CVRFs (β(SE) = 0.259(0.077), p = 0.004). This was not observed in ɛ4 non-carriers. Conclusion:In cognitively normal middle-aged adults, CVRF were associated with poorer cognition, particularly in the memory domain. These results support feasibility of online assessment of cardiovascular risk for cognitive impairment.

Keywords: Alzheimer’s disease, cardiovascular risk factors, diabetes mellitus, dyslipidemias, smoking

DOI: 10.3233/JAD-215375

Journal: Journal of Alzheimer's Disease, vol. 86, no. 3, pp. 1081-1091, 2022