Abstract Details

Title Cardiovascular Health Across Young Adulthood, Cerebral Autoregulation, and Cognitive Function in Midlife

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S4 - Aging and Dementia: Risk Factors and Genetics (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Objective To assess the association of cardiovascular health (CVH) across young adulthood to midlife with dynamic cerebral autoregulation (dCA) and cognition in midlife.

Background Vascular risk factors are closely linked to cerebrovascular damage and cognitive impairment in older adults. However, the significance of CVH through young adulthood in relation to dCA and cognition in midlife remains unknown.

Design/Methods We studied 189 participants from the Coronary Artery Risk Development in Young Adults study (45% females; 45% blacks). Vascular risk factors were assessed during 30 years of follow-up through 8 in-person visits. At each visit, a CVH score (range 0-10) was calculated using smoking, BMI, blood pressure, total cholesterol, and fasting glucose. At Year 30 (Y30) examination, dCA was calculated as the transfer function phase of the spontaneous oscillations in blood pressure and flow velocity in the middle cerebral artery using transcranial Doppler ultrasound. Cognition was assessed at Y30 using a series of neuropsychological tests. Multivariate linear regression models were used to assess the association of CVH at each visit with dCA and cognition.

Results Mean age at baseline (Y0) and Y30 were 24±4 and 54±4years, respectively. A better CVH at Y0 and Year 7 was associated with higher phase (better dCA, β=3.55; p=0.006 and β=3.48; p=0.005, respectively). This association was the most robust at baseline compared to consecutive visits (baseline β=3.55; p=0.006 vs Y30 β=1.704; p=0.091). Higher CVH score at baseline was associated with better cognitive performance in memory (β=0.51; p<0.05), attention (β=2.21; p<0.01), and executive (for Trails-B β=0.05; p<0.05 and for Stroop β=0.07; p<0.05) cognitive domains. All associations were independent of socio-demographics and education.

Conclusions We show a graded association between CVH during young adulthood and better dCA and cognition in midlife. A life course approach must be used to further disentangle the mechanisms underlying the impact of vascular risk factors on brain health.

Authors/Disclosures
Meghana Shownkeen, MD (Northwestern Medicine) PRESENTER	No disclosure on file
Simin Mahinrad, MD, PhD (Northwestern University Feinberg School of Medicine)	No disclosure on file
Kristine Yaffe, MD	Dr. Yaffe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Yaffe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Quintiles. Dr. Yaffe has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Alector. The institution of Dr. Yaffe has received research support from NIH. The institution of Dr. Yaffe has received research support from DOD. The institution of Dr. Yaffe has received research support from Veterans Affairs.
	No disclosure on file
Farzaneh A. Sorond, MD, PhD (Northwestern University Feinberg School of Medicine)	Dr. Sorond has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie. Dr. Sorond has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Stryker. The institution of Dr. Sorond has received research support from NIH.

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