Early adulthood and midlife cardiovascular risk factors and late‐life cognition in KHANDLE: A lifecourse study of a diverse cohort: Neuropsychology/Neuropsychological profiles of dementia: Valid biomarkers?. (7th December 2020)

• Record Type: Journal Article
• Authors: Peterson, Rachel; George, Kristen M.; Gilsanz, Paola; Mayeda, Elizabeth Rose; Glymour, M. Maria; Mungas, Dan M.; DeCarli, Charles; Whitmer, Rachel A.
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 6
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.046161
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Midlife cardiovascular risks (CVR) are associated with late‐life cognition and dementia. Prior studies that examine early and midlife CVR on cognitive aging in Asians, Blacks, and Latinos are limited. Methods: The Kaiser Healthy Aging and Diverse Life Experiences Study (KHANDLE) is a cohort of community‐dwelling Kaiser Permanente members residing in Northern California (Asians (26%), Blacks (29%), Latinos (20%) and Whites (24%)) who completed a multiphasic health checkup (MHC) from 1977‐1985 (n=1, 207; mean age=37.6). KHANDLE aims to evaluate how lifecourse factors influence late‐life brain health and cognitive decline and may impact race/ethnic disparities. Using linear regression, we examined the association between late‐life cognition and early/midlife hypertension, hyperlipidemia and overweight/obesity collected at MHC. Executive function, semantic memory and verbal episodic memory measured using the Spanish and English Neuropsychological Assessment Scales (SENAS) were z‐standardized and combined for a composite measure of overall cognition. We tested for effect modification by race/ethnicity. Models controlled for age at KHANDLE, age at MHC, gender, and education. Results: At KHANDLE baseline, mean age was 75.4(6.7). At MHC, 46% of participants were ages 26‐35, 47% ages 36‐49 and 7% ages 50‐65. Prevalence of 2+ CVR was highest in Blacks (24%), followed by Latinos (24%), Asians (15%), and Whites (13%). Across race/ethnicity, having 2+ risk factors was associated with lower cognition in all domains: Overall cognition β=‐0.35 (‐0.47, ‐0.23). Having hypertension, hyperlipidemia or being overweight/obese was associated with worse cognition in all race/ethnic groups and across all cognitive domains (see table). Effect estimates varied by race/ethnicity, but interactions were not statistically significant: Blacks with hypertension (n=108) had lower late‐life cognition than other groups, especially for semantic memory and verbal episodic memory; Latinos with hyperlipidemia (n=49) had worse verbal memory than other groups; whites who were overweight/obese (n=84) had lower late‐life cognition across all domains, while Asians who were overweight/obese (n=50) had better late‐life cognition than non‐Asian participants who were overweight/obese. Conclusions: Early/midlife cardiovascular risk factors are associated with lower late‐life cognition in all race/ethnic groups. The association between specific cardiovascular risk factors and late‐life cognition may vary by race/ethnicity, but differences were not significant.