Abstract Details

Title Midlife Cardiac Structure And Function Are Associated With Lower Midlife Cognition: the CARDIA Study

Topic General Neurology

Presentation(s) S21 - Neuroepidemiology (2:08 PM-2:16 PM)

Poster/Presentation
Number 002

Background Cardiovascular risk factors are critical modifiable risk factors for cognitive aging, yet less is known about the role of subclinical abnormalities in cardiac structure and function and their adverse effects on the brain, possibly from decreased perfusion.

Objective To investigate the association between midlife cardiac structure and function and midlife cognition.

Design/Methods We studied 2,516 participants from the CARDIA (Coronary Artery Risk Development in Young Adults) Study. Echocardiograms were obtained at Year 25 (mean age 50 years) to assess left ventricular (LV) mass (LVM); LV systolic function with LV ejection fraction (LVEF); LV diastolic function with left atrial volume (LAV) and early peak mitral velocity (E)/early peak mitral annular velocity (e’) ratio. Cognition was assessed at Year 30 using 6 cognitive tests: Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Stroop, Rey Auditory Verbal Learning Test (RAVLT) and category and letter fluency. Linear mixed regressions were used to assess the association between cardiac structure and function and cognition.

Results Of 2,516 participants, 57% were women and 46% black; mean age was 50.2 (3.6) years. Higher LVM (≥ 1-SD) was associated with lower cognition on most tests: MoCA (22.6 vs. 24.2), DSST (62.0 vs. 69.7), Stroop (25.4 vs. 22.1) and RAVLT (7.3 vs. 8.8) (all p ≤ 0.001). Higher LAV was associated with lower cognition on MoCA (23.0 vs. 24.1) and RAVLT (7.9 vs. 8.7) (all p ≤ 0.001). Similar findings were observed with higher E/e’ ratio and DSST, Stroop and RAVLT. Adjustment for (1) demographics, education and (2) hypertension, diabetes, and smoking did not notably change the results. Lower LVEF was no longer associated with cognition after adjustment.

Conclusions Even before the occurrence of any cardiovascular disease, midlife subclinical abnormalities in cardiac structure and diastolic function were associated with lower midlife cognition.

Authors/Disclosures
Laure Rouch (University of California, San Francisco) PRESENTER	Laure Rouch has nothing to disclose.
Laure Rouch (University of California, San Francisco)	Laure Rouch has nothing to disclose.
	No disclosure on file
Stephen Sidney, MD, MPH (Kaiser Permanente Northern California Division of Research)	Dr. Sidney has nothing to disclose.
	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.