The Association of Heart/Vascular Aging with Mild Cognitive Impairment in a Rural Multiethnic Cohort: The Project FRONTIER Study

IF 8.5 3区 医学 Q1 CLINICAL NEUROLOGY
D. Appiah, G. Ashworth, A. Boles, N. Nair
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Abstract

Background Cardiovascular disease (CVD) and Alzheimer’s disease and related dementias (ADRD) disproportionately affect rural communities. Identifying strategies to effectively communicate CVD risk to prevent these conditions remains a high priority. Objective We assessed the relation between predicted heart/vascular age (PHA), an easily communicated metric of CVD risk, and mild cognitive impairment (MCI), an early manifestation of ADRD. Design, Setting, Participants Data were from 967 rural West Texas residents aged ≥40 years without CVD at baseline (2009–2012) enrolled in Project FRONTIER, an ongoing, multiethnic cohort study on cognitive aging. Measurements MCI was diagnosed using the standardized consensus review criteria. PHA was calculated using the Framingham CVD risk equation. High excess PHA (HEPHA) was defined as the difference between PHA and chronological age >5 years. Logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI). Result At baseline, the mean age of participants (70% women and 64% Hispanics) was 55 years. Almost 13% had MCI and 65% had HEPHA. After adjusting for socio-demographic and health factors, HEPHA was positively associated with MCI (OR=2.98; 95%CI: 1.72–5.15). Among participants without MCI at baseline who returned for follow-up exam after three years (n=238), a three-year negative change in PHA was seemingly associated with reduced odds for MCI (OR=0.98; 95%CI: 0.96–1.01). Conclusions In this study, PHA was positively associated with MCI, with improvement in CVD risk profile seemingly related to reduced odds for MCI. PHA may provide a low-cost means of communicating CVD risk in rural settings to prevent both CVD and ADRD.
农村多民族队列心脏/血管老化与轻度认知障碍的关联:项目前沿研究
背景心血管疾病(CVD)和阿尔茨海默病及相关痴呆(ADRD)对农村社区的影响尤为严重。确定有效沟通心血管疾病风险的策略以预防这些情况仍然是当务之急。目的我们评估了预测的心脏/血管年龄(PHA)(一种易于沟通的CVD风险指标)与轻度认知障碍(MCI)(ADRD的早期表现)之间的关系。设计、设置、参与者数据来自967名基线时(2009-2012年)年龄≥40岁且无心血管疾病的西得克萨斯州农村居民,他们参加了FRONTIER项目,这是一项正在进行的关于认知衰老的多民族队列研究。测量MCI使用标准化一致性审查标准进行诊断。PHA使用Framingham CVD风险方程进行计算。高过量PHA(HEPHA)被定义为PHA与年龄>5岁之间的差异。逻辑回归模型用于计算比值比(OR)和95%置信区间(CI)。结果基线时,参与者的平均年龄(70%为女性,64%为西班牙裔)为55岁。近13%患有MCI,65%患有HEPHA。在调整了社会人口和健康因素后,HEPHA与MCI呈正相关(OR=2.98;95%CI:1.72-5.15)。在基线时没有MCI的参与者中,三年后返回进行随访检查(n=238),PHA的三年负变化似乎与MCI的几率降低有关(OR=0.98;95%CI:0.96–1.01)。结论在本研究中,PHA与MCI呈正相关,CVD风险状况的改善似乎与MCI的几率降低有关。PHA可以在农村环境中提供一种低成本的沟通CVD风险的方式,以预防CVD和ADRD。
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来源期刊
自引率
7.80%
发文量
85
期刊介绍: The JPAD « Journal of Prevention of Alzheimer’Disease » will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including : neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes. JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.
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