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Abstract Details

Life’s Essential 8 and Brain Health Clinical Outcomes in Middle-aged Adults
General Neurology
P2 - Poster Session 2 (11:45 AM-12:45 PM)
15-003
To test the hypothesis that worse Life’s Essential 8 (LE8) profiles are associated with higher composite risk of the most important clinical endpoints related to brain health.

There is a strong connection between cardiovascular risk during middle age and brain health later in life. The American Heart Association’s LE8 constitute a validated tool that captures key determinants of cardiovascular health.
We conducted a two-stage (discovery and replication) prospective study using the UK Biobank (UKB) and All of Us (AoU). Participants with prior stroke, dementia, or late life depression (LLD) were excluded. The exposure was the LE8 score, comprised of eight components (blood pressure, glucose, and cholesterol, body mass index, smoking, physical activity, diet, and sleep), organized in 3 categories (optimal, intermediate, and poor). The outcome was a composite of stroke, dementia, or LLD. We evaluated the associations of interest via multivariable Cox proportional hazard models.
The discovery included 303,951 UKB participants (mean age 57, 52% female), in whom the unadjusted incidence of the composite outcome was 442 (0.7%), 2,082 (1.1%) and 1,015 (1.8%) in participants with optimal, intermediate, and poor cardiovascular health, respectively (p<0.001). Results remained significant in multivariable Cox models (optimal versus poor cardiovascular health HR 2.01;95%CI 1.80 – 2.25;p-trend<0.001). The replication included 92,551 AoU participants (mean age 57, 59% female), in whom the unadjusted incidence of the composite outcome was 547 (3%), 3,449 (6.2%) and 1,833 (10%) in participants with optimal, intermediate, and poor cardiovascular health, respectively (p<0.001). Results remained significant in multivariable Cox models (optimal versus poor cardiovascular health HR 2.02;95%CI 1.83 – 2.23;p-trend<0.001).
Among middle-aged UKB and AoU participants, poorer cardiovascular health profiles were strongly associated with higher risks of developing a composite endpoint capturing the most important brain health related diseases. These findings support the utilization of this endpoint in brain health focused clinical trials.
Authors/Disclosures
Santiago Clocchiatti-Tuozzo (Yale University, Department of Neurology)
PRESENTER 		Mr. Clocchiatti-Tuozzo has nothing to disclose.
Cyprien Rivier, MD (Yale University) Dr. Rivier has nothing to disclose.
Daniela B. Renedo, MD (Yale University) Dr. Renedo has nothing to disclose.
Shufan Huo, MD, PhD (Yale University) Dr. Huo has nothing to disclose.
Victor M. Torres-Lopez, MA (Yale University) Mr. Torres-Lopez has nothing to disclose.
Adam De Havenon, MD, FAAN (Yale University) Dr. De Havenon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novo Nordisk. Dr. De Havenon has or had stock in Certus.Dr. De Havenon has or had stock in TitinKM. The institution of Dr. De Havenon has received research support from NIH/NINDS. Dr. De Havenon has received publishing royalties from a publication relating to health care.
Kevin N. Sheth, MD, FAAN (Yale UniversityDivision of Neuro and Critical Care) Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.
Thomas Gill Thomas Gill has nothing to disclose.
Guido J. Falcone, MD (Yale School of Medicine) The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.