The influence of vascular risk factors and stroke on cognition in late life analysis of the NACC cohort

Anand Viswanathan, Eric A. Macklin, Rebecca Betensky, Bradley Hyman, Eric E. Smith, Deborah Blacker

Research output: Contribution to journalArticle

Abstract

Objective: Vascular risk factors in mid-life predict late life cognitive decline in previously normal populations. We sought to investigate the contribution of vascular risk factors in late life to cognitive decline in a cohort of normal elderly individuals. Methods: Cognitively normal subjects were identified from the longitudinal cohort of participants in the National Alzheimer Coordinating Center (NACC) database (n=2975). The association between a composite score of vascular risk factors (based on the Framingham Stroke Risk Profile) and cognitive function was tested at baseline visit and estimated in longitudinal analyses using linear mixed-effects models. Results: Total vascular risk factor burden was associated with worse cognitive performance at baseline and faster decline longitudinally in univariate analyses but only with worse WAIS digit symbol performance in cross-sectional (estimate=-0.266 units/1 unit of Framingham Stroke Risk Profile Score; 95% confidence interval,-0.380 to-0.153; P<0.001) and longitudinal (estimate=-0.034 units/1 unit of Framingham Stroke Risk Profile Score/year; 95% confidence interval,-0.055 to-0.012; P=0.002) analyses after adjusting for age, education, and APOE genotype. Individuals with history of stroke performed significantly worse on the trails B, category fluency, and Boston naming tests in cross-sectional analyses and in delayed logical memory and digit span backwards in longitudinal analyses. Conclusions: Although the modified Framingham Stroke Risk Profile in late-life predicts rate of decline on selective neurocognitive measures in previously normal elderly individuals, age appears to be the strongest risk factor for cognitive impairment in this population. History of stroke independently influences rate of cognitive decline in these individuals.

Original languageEnglish (US)
Pages (from-to)287-293
Number of pages7
JournalAlzheimer Disease and Associated Disorders
Volume29
Issue number4
DOIs
StatePublished - Jan 1 2015

Fingerprint

Cognition
Stroke
Repression (Psychology)
Confidence Intervals
Population
vascular factor
Cross-Sectional Studies
Genotype
Databases
Education
Cognitive Dysfunction

Keywords

  • Cerebrovascular disease
  • Cognitive decline
  • Cognitively normal
  • Framingham stroke risk profile
  • Stroke
  • Vascular risk factors

ASJC Scopus subject areas

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

The influence of vascular risk factors and stroke on cognition in late life analysis of the NACC cohort. / Viswanathan, Anand; Macklin, Eric A.; Betensky, Rebecca; Hyman, Bradley; Smith, Eric E.; Blacker, Deborah.

In: Alzheimer Disease and Associated Disorders, Vol. 29, No. 4, 01.01.2015, p. 287-293.

Research output: Contribution to journalArticle

Viswanathan, Anand ; Macklin, Eric A. ; Betensky, Rebecca ; Hyman, Bradley ; Smith, Eric E. ; Blacker, Deborah. / The influence of vascular risk factors and stroke on cognition in late life analysis of the NACC cohort. In: Alzheimer Disease and Associated Disorders. 2015 ; Vol. 29, No. 4. pp. 287-293.
@article{4f943a5e4f7c497b91f48bd64a221748,
title = "The influence of vascular risk factors and stroke on cognition in late life analysis of the NACC cohort",
abstract = "Objective: Vascular risk factors in mid-life predict late life cognitive decline in previously normal populations. We sought to investigate the contribution of vascular risk factors in late life to cognitive decline in a cohort of normal elderly individuals. Methods: Cognitively normal subjects were identified from the longitudinal cohort of participants in the National Alzheimer Coordinating Center (NACC) database (n=2975). The association between a composite score of vascular risk factors (based on the Framingham Stroke Risk Profile) and cognitive function was tested at baseline visit and estimated in longitudinal analyses using linear mixed-effects models. Results: Total vascular risk factor burden was associated with worse cognitive performance at baseline and faster decline longitudinally in univariate analyses but only with worse WAIS digit symbol performance in cross-sectional (estimate=-0.266 units/1 unit of Framingham Stroke Risk Profile Score; 95{\%} confidence interval,-0.380 to-0.153; P<0.001) and longitudinal (estimate=-0.034 units/1 unit of Framingham Stroke Risk Profile Score/year; 95{\%} confidence interval,-0.055 to-0.012; P=0.002) analyses after adjusting for age, education, and APOE genotype. Individuals with history of stroke performed significantly worse on the trails B, category fluency, and Boston naming tests in cross-sectional analyses and in delayed logical memory and digit span backwards in longitudinal analyses. Conclusions: Although the modified Framingham Stroke Risk Profile in late-life predicts rate of decline on selective neurocognitive measures in previously normal elderly individuals, age appears to be the strongest risk factor for cognitive impairment in this population. History of stroke independently influences rate of cognitive decline in these individuals.",
keywords = "Cerebrovascular disease, Cognitive decline, Cognitively normal, Framingham stroke risk profile, Stroke, Vascular risk factors",
author = "Anand Viswanathan and Macklin, {Eric A.} and Rebecca Betensky and Bradley Hyman and Smith, {Eric E.} and Deborah Blacker",
year = "2015",
month = "1",
day = "1",
doi = "10.1097/WAD.0000000000000080",
language = "English (US)",
volume = "29",
pages = "287--293",
journal = "Alzheimer Disease and Associated Disorders",
issn = "0893-0341",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - The influence of vascular risk factors and stroke on cognition in late life analysis of the NACC cohort

AU - Viswanathan, Anand

AU - Macklin, Eric A.

AU - Betensky, Rebecca

AU - Hyman, Bradley

AU - Smith, Eric E.

AU - Blacker, Deborah

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective: Vascular risk factors in mid-life predict late life cognitive decline in previously normal populations. We sought to investigate the contribution of vascular risk factors in late life to cognitive decline in a cohort of normal elderly individuals. Methods: Cognitively normal subjects were identified from the longitudinal cohort of participants in the National Alzheimer Coordinating Center (NACC) database (n=2975). The association between a composite score of vascular risk factors (based on the Framingham Stroke Risk Profile) and cognitive function was tested at baseline visit and estimated in longitudinal analyses using linear mixed-effects models. Results: Total vascular risk factor burden was associated with worse cognitive performance at baseline and faster decline longitudinally in univariate analyses but only with worse WAIS digit symbol performance in cross-sectional (estimate=-0.266 units/1 unit of Framingham Stroke Risk Profile Score; 95% confidence interval,-0.380 to-0.153; P<0.001) and longitudinal (estimate=-0.034 units/1 unit of Framingham Stroke Risk Profile Score/year; 95% confidence interval,-0.055 to-0.012; P=0.002) analyses after adjusting for age, education, and APOE genotype. Individuals with history of stroke performed significantly worse on the trails B, category fluency, and Boston naming tests in cross-sectional analyses and in delayed logical memory and digit span backwards in longitudinal analyses. Conclusions: Although the modified Framingham Stroke Risk Profile in late-life predicts rate of decline on selective neurocognitive measures in previously normal elderly individuals, age appears to be the strongest risk factor for cognitive impairment in this population. History of stroke independently influences rate of cognitive decline in these individuals.

AB - Objective: Vascular risk factors in mid-life predict late life cognitive decline in previously normal populations. We sought to investigate the contribution of vascular risk factors in late life to cognitive decline in a cohort of normal elderly individuals. Methods: Cognitively normal subjects were identified from the longitudinal cohort of participants in the National Alzheimer Coordinating Center (NACC) database (n=2975). The association between a composite score of vascular risk factors (based on the Framingham Stroke Risk Profile) and cognitive function was tested at baseline visit and estimated in longitudinal analyses using linear mixed-effects models. Results: Total vascular risk factor burden was associated with worse cognitive performance at baseline and faster decline longitudinally in univariate analyses but only with worse WAIS digit symbol performance in cross-sectional (estimate=-0.266 units/1 unit of Framingham Stroke Risk Profile Score; 95% confidence interval,-0.380 to-0.153; P<0.001) and longitudinal (estimate=-0.034 units/1 unit of Framingham Stroke Risk Profile Score/year; 95% confidence interval,-0.055 to-0.012; P=0.002) analyses after adjusting for age, education, and APOE genotype. Individuals with history of stroke performed significantly worse on the trails B, category fluency, and Boston naming tests in cross-sectional analyses and in delayed logical memory and digit span backwards in longitudinal analyses. Conclusions: Although the modified Framingham Stroke Risk Profile in late-life predicts rate of decline on selective neurocognitive measures in previously normal elderly individuals, age appears to be the strongest risk factor for cognitive impairment in this population. History of stroke independently influences rate of cognitive decline in these individuals.

KW - Cerebrovascular disease

KW - Cognitive decline

KW - Cognitively normal

KW - Framingham stroke risk profile

KW - Stroke

KW - Vascular risk factors

UR - http://www.scopus.com/inward/record.url?scp=84948088599&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948088599&partnerID=8YFLogxK

U2 - 10.1097/WAD.0000000000000080

DO - 10.1097/WAD.0000000000000080

M3 - Article

VL - 29

SP - 287

EP - 293

JO - Alzheimer Disease and Associated Disorders

JF - Alzheimer Disease and Associated Disorders

SN - 0893-0341

IS - 4

ER -