Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Nov 2024)

Associations Between Atherosclerosis and Subsequent Cognitive Decline: A Prospective Cohort Study

  • Jie Liang,
  • Yang Pan,
  • Wenya Zhang,
  • Darui Gao,
  • Jingya Ma,
  • Yanyu Zhang,
  • Mengmeng Ji,
  • Yiwen Dai,
  • Yuling Liu,
  • Yongqian Wang,
  • Yidan Zhu,
  • Bin Lu,
  • Wuxiang Xie,
  • Fanfan Zheng

DOI
https://doi.org/10.1161/JAHA.124.036696
Journal volume & issue
Vol. 13, no. 21

Abstract

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Background This study aimed to examine whether baseline atherosclerosis was associated with subsequent short‐term domain‐specific cognitive decline. Methods and Results This research was based on the BRAVE (Beijing Research on Aging and Vessel) study, a population‐based prospective cohort study of adults aged 40 to 80 years, free of dementia. At baseline (wave 1, 2019), cognitive assessments and atherosclerosis measures, including carotid intima‐media thickness, carotid plaques, coronary artery calcification, and brachial–ankle pulse wave velocity were conducted. Cognitive function was reassessed in wave 2 (2022–2023) using linear mixed models for analysis. A total of 932 participants (63.7% women; mean age, 60.0±6.9 years) were included. Compared with the lowest tertile of carotid intima‐media thickness, carotid plaques, and brachial–ankle pulse wave velocity, or a coronary artery calcification score=0, the highest tertile of carotid intima‐media thickness (β=−0.065 SD/y [95% CI, −0.112 to −0.017]; P=0.008), carotid plaques (β=−0.070 SD/y [95% CI, −0.130 to −0.011]; P=0.021), and brachial–ankle pulse wave velocity (β=−0.057 SD/y [95% CI, −0.105 to −0.010]; P=0.018), and a coronary artery calcification score≥400 (β=−0.081 SD/y [95% CI, −0.153 to −0.008]; P=0.029) were significantly associated with a faster decline in semantic fluency after multivariable adjustment. Moreover, greater carotid intima‐media thickness, coronary artery calcification, and brachial–ankle pulse wave velocity were significantly associated with a faster decline in global cognition. Conclusions More significant atherosclerosis was associated with faster semantic fluency and global cognition declines.

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