Cardiometabolic disease, cognitive decline, and brain structure in middle and older age

Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring Pub Date : 2024-04-01 DOI:10.1002/dad2.12566

Abigail Dove, Jie Guo, Jiao Wang, D. L. Vetrano, Sakura Sakakibara, E. Laukka, David A. Bennett, Weili Xu

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Abstract

Abstract INTRODUCTION The presence of multiple cardiometabolic diseases (CMDs) has been linked to increased dementia risk, but the combined influence of CMDs on cognition and brain structure across the life course is unclear. METHODS In the UK Biobank, 46,562 dementia‐free participants completed a cognitive test battery at baseline and a follow‐up visit 9 years later, at which point 39,306 also underwent brain magnetic resonance imaging. CMDs (diabetes, heart disease, and stroke) were ascertained from medical records. Data were analyzed using age‐stratified (middle age [< 60] versus older [≥ 60]) mixed‐effects models and linear regression. RESULTS A higher number of CMDs was associated with significantly steeper global cognitive decline in older (β = –0.008; 95% confidence interval: −0.012, −0.005) but not middle age. Additionally, the presence of multiple CMDs was related to smaller total brain volume, gray matter volume, white matter volume, and hippocampal volume and larger white matter hyperintensity volume, even in middle age. DISCUSSION CMDs are associated with cognitive decline in older age and poorer brain structural health beginning already in middle age. Highlights We explored the association of CMDs with cognitive decline and brain MRI measures. CMDs accelerated cognitive decline in older (≥60y) but not middle (<60) age. CMDs were associated with poorer brain MRI parameters in both middle and older age. Results highlight the connection between CMDs and cognitive/brain aging.

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中老年人的心脏代谢疾病、认知能力下降和大脑结构

摘要引言多种心脏代谢疾病（CMDs）的存在与痴呆症风险的增加有关，但CMDs在整个生命过程中对认知和大脑结构的综合影响尚不清楚。方法在英国生物库中，46,562 名未患痴呆症的参与者在基线和 9 年后的随访中完成了认知测试，39,306 名参与者还接受了脑磁共振成像检查。CMD（糖尿病、心脏病和中风）是根据医疗记录确定的。数据采用年龄分层（中年[<60]与老年[≥60]）混合效应模型和线性回归进行分析。结果老年患者（β = -0.008；95% 置信区间：-0.012, -0.005）而中年患者（β = -0.008；95% 置信区间：-0.012, -0.005）的CMD数量越多，其整体认知能力下降越明显。此外，即使在中年，存在多个 CMD 也与较小的总脑体积、灰质体积、白质体积和海马体积以及较大的白质高密度体积有关。讨论 CMD 与老年认知能力下降和中年开始的脑结构健康状况较差有关。亮点我们探讨了 CMDs 与认知能力下降和脑磁共振成像测量的关系。CMD会加速老年（≥60岁）认知能力的衰退，但不会加速中年（<60岁）认知能力的衰退。在中老年，CMDs 与较差的脑磁共振成像参数有关。研究结果凸显了CMD与认知/脑衰老之间的联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring

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