Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline

Background and aimPrevious studies on cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) and cognitive trajectories mainly focus on Western populations and most of them have used a single measure of cardiovascular risk. In this study, among middle-aged an...

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Main Authors: Xiaoli Ji, Hui Gao, Daoyuan Sun, Wensui Zhao, Jianlin Zhuang, Kan Wang, Fariba Ahmadizar
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Aging Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2022.895188/full
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author Xiaoli Ji
Hui Gao
Daoyuan Sun
Wensui Zhao
Jianlin Zhuang
Kan Wang
Fariba Ahmadizar
author_facet Xiaoli Ji
Hui Gao
Daoyuan Sun
Wensui Zhao
Jianlin Zhuang
Kan Wang
Fariba Ahmadizar
author_sort Xiaoli Ji
collection DOAJ
description Background and aimPrevious studies on cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) and cognitive trajectories mainly focus on Western populations and most of them have used a single measure of cardiovascular risk. In this study, among middle-aged and older Chinese, we investigated (i) the association of baseline FGCRS with subsequent cognitive decline and (ii) the association of FGCRS change with concomitant cognitive decline.Materials and methodsIn wave 1 to wave 4 (2011–2018) of the China Health and Retirement Longitudinal Study, global cognition was assessed by orientation, memory, and executive function. FGCRS was assessed and categorized into tertiles (low, intermediate, and high) at baseline (2011) and 4 years after (2015). Furthermore, external validation was performed to check its generalizability using the English Longitudinal Study of Ageing (ELSA) 2008–2018.ResultsIn total, 6,402 participants with a mean [standard deviation (SD) age of 57.8 (8.4) years, 49.0% women] with complete baseline data and at least one reassessment of cognitive function were included. A 10% increment in baseline FGCRS was associated with a faster decline in global cognition (−0.010 SD/year, 95% CI −0.013, −0.008). Among 4,336 participants [mean (SD) age of 57.8 (8.2) years, 50.0% women] with data on FGCRS changes, compared to individuals with the consistently low FGCRS (reference group), a faster global cognition decline rate was observed in the low to intermediate group (−0.026 SD/year, 95% CI −0.045, −0.007), the low to high group (−0.052 SD/year, 95% CI −0.102, −0.001), the consistently intermediate group (−0.019 SD/year, 95% CI −0.033, −0.005), the intermediate to high group (−0.040 SD/year, 95% CI −0.058, −0.022), the high to intermediate group (−0.024 SD/year, 95% CI −0.047, −0.002), and the consistently high group (−0.047 SD/year, 95% CI −0.060, −0.034). Similar trends were observed for individual cognitive domains. Results from the external validation using the ELSA remained consistent.ConclusionHigher baseline FGCRS was associated with faster cognitive decline. However, there was no consistent relationship between the direction of changes in FGCRS and cognitive decline.
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spelling doaj.art-818cc5ef648241848fb7f4f87e8afa662022-12-22T02:13:21ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652022-09-011410.3389/fnagi.2022.895188895188Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive declineXiaoli Ji0Hui Gao1Daoyuan Sun2Wensui Zhao3Jianlin Zhuang4Kan Wang5Fariba Ahmadizar6Department of Occupational Disease, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaChangning Center for Disease Control and Prevention, Shanghai, ChinaDepartment of Occupational Disease, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaChangning Center for Disease Control and Prevention, Shanghai, ChinaChangning Center for Disease Control and Prevention, Shanghai, ChinaDepartment of Epidemiology, Erasmus Medical Center, Rotterdam, NetherlandsDepartment of Data Science and Biostatistics, University Medical Center Utrecht, Utrecht, NetherlandsBackground and aimPrevious studies on cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) and cognitive trajectories mainly focus on Western populations and most of them have used a single measure of cardiovascular risk. In this study, among middle-aged and older Chinese, we investigated (i) the association of baseline FGCRS with subsequent cognitive decline and (ii) the association of FGCRS change with concomitant cognitive decline.Materials and methodsIn wave 1 to wave 4 (2011–2018) of the China Health and Retirement Longitudinal Study, global cognition was assessed by orientation, memory, and executive function. FGCRS was assessed and categorized into tertiles (low, intermediate, and high) at baseline (2011) and 4 years after (2015). Furthermore, external validation was performed to check its generalizability using the English Longitudinal Study of Ageing (ELSA) 2008–2018.ResultsIn total, 6,402 participants with a mean [standard deviation (SD) age of 57.8 (8.4) years, 49.0% women] with complete baseline data and at least one reassessment of cognitive function were included. A 10% increment in baseline FGCRS was associated with a faster decline in global cognition (−0.010 SD/year, 95% CI −0.013, −0.008). Among 4,336 participants [mean (SD) age of 57.8 (8.2) years, 50.0% women] with data on FGCRS changes, compared to individuals with the consistently low FGCRS (reference group), a faster global cognition decline rate was observed in the low to intermediate group (−0.026 SD/year, 95% CI −0.045, −0.007), the low to high group (−0.052 SD/year, 95% CI −0.102, −0.001), the consistently intermediate group (−0.019 SD/year, 95% CI −0.033, −0.005), the intermediate to high group (−0.040 SD/year, 95% CI −0.058, −0.022), the high to intermediate group (−0.024 SD/year, 95% CI −0.047, −0.002), and the consistently high group (−0.047 SD/year, 95% CI −0.060, −0.034). Similar trends were observed for individual cognitive domains. Results from the external validation using the ELSA remained consistent.ConclusionHigher baseline FGCRS was associated with faster cognitive decline. However, there was no consistent relationship between the direction of changes in FGCRS and cognitive decline.https://www.frontiersin.org/articles/10.3389/fnagi.2022.895188/fullFramingham General Cardiovascular Risk Scorechangecognitive declineolder peoplecohort
spellingShingle Xiaoli Ji
Hui Gao
Daoyuan Sun
Wensui Zhao
Jianlin Zhuang
Kan Wang
Fariba Ahmadizar
Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline
Frontiers in Aging Neuroscience
Framingham General Cardiovascular Risk Score
change
cognitive decline
older people
cohort
title Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline
title_full Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline
title_fullStr Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline
title_full_unstemmed Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline
title_short Association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline
title_sort association of baseline level of cardiovascular risk burden and its temporal changes with cognitive decline
topic Framingham General Cardiovascular Risk Score
change
cognitive decline
older people
cohort
url https://www.frontiersin.org/articles/10.3389/fnagi.2022.895188/full
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