1
|
Beydoun MA, Beydoun HA, Hu YH, Maino Vieytes CA, Noren Hooten N, Song M, Georgescu MF, Fanelli-Kuczmarski MT, Meirelles O, Launer LJ, Evans MK, Zonderman AB. Plasma proteomic biomarkers and the association between poor cardiovascular health and incident dementia: The UK Biobank study. Brain Behav Immun 2024; 119:995-1007. [PMID: 38710337 PMCID: PMC11285716 DOI: 10.1016/j.bbi.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/04/2024] [Accepted: 05/02/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The study examined how plasma proteome indicators may explain the link between poor cardiovascular health (CVH) and dementia risk. METHODS The present study involved 28,974 UK Biobank participants aged 50-74y at baseline (2006-2010) who were followed-up for ≤ 15 y for incidence of dementia. CVH was calculated using Life's Essential 8 (LE8) total scores. The scores were standardized and reverse coded to reflect poor CVH (LE8z_rev). OLINK proteomics was available on this sample (k = 1,463 plasma proteins). The study primarily tested the mediating effects of the plasma proteome in LE8z_rev-dementia effect. The total effect was decomposed into "mediation only" or pure indirect effect (PIE), "interaction only" or interaction referent (INTREF), "neither mediation nor interaction" or controlled direct effect (CDE), and "both mediation and interaction" or mediated interaction (INTMED). RESULTS The study found poorer CVH assessed by LE8z_rev increased the risk of all-cause dementia by 11 % [per 1 SD, hazard ratio, (HR) = 1.11, 95 % CI: 1.03-1.20, p = 0.005). The study identified 11 plasma proteins with strong mediating effects, with GDF15 having the strongest association with dementia risk (per 1 SD, HR = 1.24, 95 % CI: 1.16, 1.33, P < 0.001 when LE8z_rev is set at its mean value) and the largest proportion mediated combining PIE and INTMED (62.6 %; 48 % of TE is PIE), followed by adrenomedullin or ADM. A first principal component with 10 top mediators (TNFRSF1A, GDF15, FSTL3, COL6A3, PLAUR, ADM, GFRAL, ACVRL1, TNFRSF6B, TGFA) mediated 53.6 % of the LE8z_rev-dementia effect. Using all the significant PIE (k = 526) proteins, we used OLINK Insight pathway analysis to identify key pathways, which revealed the involvement of the immune system, signal transduction, metabolism, disease, protein metabolism, hemostasis, membrane trafficking, extracellular matrix organization, developmental biology, and gene expression among others. STRING analysis revealed that five top consistent proteomic mediators were represented in two larger clusters reflecting numerous interconnected biological gene ontology pathways, most notably cytokine-mediated signaling pathway for GDF15 cluster (GO:0019221) and regulation of peptidyl-tyrosine phosphorylation for the ADM cluster (GO:0050730). CONCLUSION Dementia is linked to poor CVH mediated by GDF15 and ADM among several key proteomic markers which collectively explained ∼ 54 % of the total effect.
Collapse
Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States.
| | - Hind A Beydoun
- VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Washington, DC 20420, United States; Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, United States
| | - Yi-Han Hu
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Christian A Maino Vieytes
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Minkyo Song
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Michael F Georgescu
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Marie T Fanelli-Kuczmarski
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Osorio Meirelles
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21224, United States
| |
Collapse
|
2
|
Aguilar-Navarro SG, Yeverino-Castro SG, Mejía-Arango S, Moctezuma R, Juárez-Cedillo T, Mimenza-Alvarado AJ. Brain health index as a predictor of possible vascular dementia in the Mexican health and aging study 2012-2015. PLoS One 2024; 19:e0304234. [PMID: 38781152 PMCID: PMC11115212 DOI: 10.1371/journal.pone.0304234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
To determine the burden of disease among subjects at risk of developing stroke or dementia, brain health indexes (BHI) tend to rely on anatomical features. Recent definitions emphasize the need of a broader perspective that encompasses cardiovascular risk factors (CVRFS) and lifestyle components which can be considered partial contributors to optimal brain health. In this study, we aimed to establish the association and risk detected by a Brain Health Index and the risk of possible vascular dementia (PVD) using data from the Mexican Health and Aging Study (MHAS) 2012-2015. The MHAS is a longitudinal study of adults aged ≥ 50 years. We analyzed the data obtained between 2012 and 2015. CVRFS included in the index were diabetes mellitus, hypertension, myocardial infarction, depression, obesity, physical inactivity, and smoking history. A PVD diagnosis was established when scores in the Cross-Cultural Cognitive Examination were below reference norms and limitations in ≥1 instrumental activities of daily living and a history of stroke were present. A multinomial regression model was developed to determine the association between BHI scores and PVD. In 2015, 75 PVD cases were identified. Mean age was 67.1 ±13.2 years, 35.8% were female, and the mean educational level was 5.8 ±5.5 years. In cases with a higher score in the BHI, the model revealed a hazards ratio of 1.63 (95% CI: 1.63-1.64, p< 0.001) for PVD. In this longitudinal study, with the use of a feasible multifactorial BHI in the Mexican population, a greater score was associated with a 1.63-fold risk of developing PVD during the 3-year follow-up, while the risk for stroke was 1.75. This index could potentially be used to predict the risk of PVD in adults with modifiable CVRFS.
Collapse
Affiliation(s)
- Sara G. Aguilar-Navarro
- Deparment of Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
| | - Sara G. Yeverino-Castro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
- CHRISTUS Center of Excellence and Innovation, San Pedro Garza García, Nuevo León, México
| | - Silvia Mejía-Arango
- Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, México
| | - Rogelio Moctezuma
- Deparment of Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
| | - Teresa Juárez-Cedillo
- Epidemiologic and Health Service Research Unit, Aging Area, Mexican Institute of Social Security, National Medical Center Century XXI, Mexico City, Mexico
| | - Alberto José Mimenza-Alvarado
- Deparment of Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City, Mexico
| |
Collapse
|
3
|
Palacios N, Gordon S, Wang T, Burk R, Qi Q, Huttenhower C, Gonzalez HM, Knight R, De Carli C, Daviglus M, Lamar M, Telavera G, Tarraf W, Kosciolek T, Cai J, Kaplan RC. Gut Microbiome Multi-Omics and Cognitive Function in the Hispanic Community Health Study/Study of Latinos- Investigation of Neurocognitive Aging. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.17.24307533. [PMID: 38798527 PMCID: PMC11118626 DOI: 10.1101/2024.05.17.24307533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
INTRODUCTION We conducted a study within the Hispanic Community Health Study/Study of Latinos- Investigation of Neurocognitive Aging (HCHS/SOL-INCA) cohort to examine the association between gut microbiome and cognitive function. METHODS We analyzed the fecal metagenomes of 2,471 HCHS/SOL-INCA participants to, cross-sectionally, identify microbial taxonomic and functional features associated with global cognitive function. Omnibus (PERMANOVA) and feature-wise analyses (MaAsLin2) were conducted to identify microbiome-cognition associations, and specific microbial species and pathways (Kyoto Encyclopedia of Genes and Genomes (KEGG modules) associated with cognition. RESULTS Eubacterium species( E. siraeum and E. eligens ), were associated with better cognition. Several KEGG modules, most strongly Ornithine, Serine biosynthesis and Urea Cycle, were associated with worse cognition. DISCUSSION In a large Hispanic/Latino cohort, we identified several microbial taxa and KEGG pathways associated with cognition.
Collapse
|
4
|
Estrella ML, Tarraf W, Kuwayama S, Gallo LC, Wu B, Marquine MJ, Perreira KM, Vasquez PM, Isasi CR, Lipton RB, Mattei J, González HM, Daviglus ML, Lamar M. Psychosocial factors associated with 7-year change in cognition among middle-aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) and Sociocultural ancillary studies. Alzheimers Dement 2024; 20:1137-1148. [PMID: 37897802 PMCID: PMC10916974 DOI: 10.1002/alz.13527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/02/2023] [Accepted: 10/06/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Few studies have examined the associations of psychosocial factors with cognitive change in Hispanics/Latinos. METHODS Data from the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL INCA) and Sociocultural studies were used (n = 2,155; ages ≥45 years). Psychosocial exposures included intrapersonal (ethnic identity, optimism, purpose in life), interpersonal (family cohesion, familism, social networks, social support), and social factors (ethnic discrimination, loneliness, subjective social status). Survey-linear regression models examined associations between psychosocial exposures and 7-year cognitive change (global cognition [GC], verbal learning, memory, word fluency [WF], and digit symbol substitution [DSS]). RESULTS Familism predicted decline in GC, verbal learning, and memory; family cohesion predicted DSS decline; and loneliness predicted memory decline. Ethnic identity was protective against decline in GC and memory, optimism and social support were protective against decline in memory, and purpose in life was protective against WF decline. DISCUSSION Psychosocial factors are differentially related to cognitive changes. Culturally relevant factors should be explored in Hispanic/Latino cognitive aging research. HIGHLIGHTS Psychosocial factors are differentially related to cognitive changes in Latinos. Role of culturally relevant factors on cognition should be further explored. Familism predicted decline in global cognition, verbal learning, and memory. Ethnic identity predicted increase in global cognition and memory.
Collapse
Affiliation(s)
- Mayra L. Estrella
- Department of EpidemiologyHuman Genetics and Environmental SciencesUniversity of Texas Health Sciences Center at Houston (UTHealth Houston) School of Public HealthBrownsvilleTexasUSA
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Sayaka Kuwayama
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Benson Wu
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - María J. Marquine
- Departments of Medicine and PsychiatryDuke Center for the Study of Aging and Human DevelopmentDuke UniversityDurhamNorth CarolinaUSA
| | - Krista M. Perreira
- Department of Social MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | - Priscilla M. Vasquez
- Department of Urban Public HealthCharles R. Drew University of Medicine and ScienceLos AngelesCaliforniaUSA
| | - Carmen R. Isasi
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of MedicineNew YorkNew YorkUSA
| | - Josiemer Mattei
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| |
Collapse
|
5
|
Petermann-Rocha F, Deo S, Lyall D, Orkaby AR, Quinn TJ, Sattar N, Celis-Morales C, Pell JP, Ho FK. Association Between the AHA Life's Essential 8 Score and Incident All-Cause Dementia: A Prospective Cohort Study from UK Biobank. Curr Probl Cardiol 2023; 48:101934. [PMID: 37422047 DOI: 10.1016/j.cpcardiol.2023.101934] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Abstract
This study aimed to investigate the association between the Life's Essential 8 (LE8) score and incident all-cause dementia (including Alzheimer's disease [AD] and vascular dementia) in UK Biobank. A total of 259,718 participants were included in this prospective study. Smoking, non-HDL cholesterol, blood pressure, body mass index, HbA1c, physical activity, diet, and sleep were used to create the Life's Essential 8 (LE8) score. Associations between the score (both continuous and as quartiles) and outcomes were investigated using adjusted Cox proportional hazard models. The potential impact fractions of 2 scenarios and the rate advancement periods were also calculated. Over a median follow-up of 10.6 years, 4958 participants were diagnosed with any dementia. Higher LE8 scores were associated with lower risk of all-cause and vascular dementia in an exponential decay pattern. Compared with individuals in the healthiest quartile, those in the least healthy quartile had a higher risk of all-cause dementia (HR: 1.50 [95% CI: 1.37-1.65] and vascular dementia (HR: 1.86 [1.44-2.42]). A targeted intervention that increased the score by 10-points among individuals in the lowest quartile could have prevented 6.8% of all-cause dementia cases. Individuals in the least healthy LE8 quartile might develop all-cause dementia 2.45 years earlier than their counterparts. In conclusion, individuals with higher LE8 scores had lower risk of all-cause and vascular dementia. Because of nonlinear associations, interventions targeted at the least healthy individuals might produce greater population-level benefits.
Collapse
Affiliation(s)
- Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Salil Deo
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Division of Cardiothoracic Surgery Surgical Services, Louis Stokes Cleveland VA Medical Center, Cleveland, OH; Case School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Donald Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Ariela R Orkaby
- New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA; Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Terence J Quinn
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom; Human Performance Laboratory, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
| |
Collapse
|
6
|
Dinesh D, Lee JS, Scott TM, Tucker KL, Palacios N. Proton Pump Inhibitor Use and Cognitive Function in the Boston Puerto Rican Health Study. J Gerontol A Biol Sci Med Sci 2023; 78:1461-1470. [PMID: 36420642 PMCID: PMC10395560 DOI: 10.1093/gerona/glac231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND There is a lack of consensus among studies on the association between proton pump inhibitor (PPI) use and cognitive impairment. This association is not well studied among minority populations, including among Puerto Ricans. Therefore, we sought to examine this association among Boston-area Puerto Ricans. METHODS The Boston Puerto Rican Health Study is an ongoing longitudinal cohort that enrolled 1499 Boston-area Puerto Rican adults, aged 45-75 years at baseline. Complete outcome and exposure data was available for 1290 baseline participants. Covariate-adjusted linear regression and linear mixed effects models were used to examine the association between PPI use, and global cognition, executive function, and memory cross-sectionally and longitudinally over ~12.7 years of follow-up. Furthermore, we examined the cross-sectional association between long-term PPI use (continuous use of ~6.2 years) and global cognition, executive function, and memory. RESULTS Among 1 290 participants at baseline, 313 (24.3%) self-reported PPI use. Baseline PPI use was not associated with baseline global cognition, executive function, or memory. Baseline PPI use also did not alter the trajectory of global cognition, executive function, or memory over ~12.7 years of follow-up. Long-term PPI use was not associated with global cognition, executive function, or memory over ~12.7 years of follow-up. CONCLUSION In this study of Boston-area Puerto Ricans, we did not observe an association between PPI use and global cognition, executive function, or memory either cross-sectionally or over 12.7 years of follow-up.
Collapse
Affiliation(s)
- Deepika Dinesh
- Center for Population Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jong Soo Lee
- Center for Population Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Department of Mathematical Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Tammy M Scott
- Center for Population Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
- Department of Psychiatry, School of Medicine, Tufts University, Boston, Massachusetts, USA
| | - Katherine L Tucker
- Center for Population Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Natalia Palacios
- Center for Population Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Department of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Department of Nutrition, Harvard University School of Public Health, Boston, Massachusetts, USA
- Geriatric Research Education Clinical Center, Department of Veterans Affairs, ENRM VA Hospital, Bedford, Massachusetts, USA
| |
Collapse
|
7
|
Pirzada A, Cai J, Heiss G, Sotres-Alvarez D, Gallo LC, Youngblood ME, Avilés-Santa ML, González HM, Isasi CR, Kaplan R, Kunz J, Lash JP, Lee DJ, Llabre MM, Penedo FJ, Rodriguez CJ, Schneiderman N, Sofer T, Talavera GA, Thyagarajan B, Wassertheil-Smoller S, Daviglus ML. Evolving Science on Cardiovascular Disease Among Hispanic/Latino Adults: JACC International. J Am Coll Cardiol 2023; 81:1505-1520. [PMID: 37045521 DOI: 10.1016/j.jacc.2023.02.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/03/2023] [Accepted: 02/07/2023] [Indexed: 04/14/2023]
Abstract
The landmark, multicenter HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is the largest, most comprehensive, longitudinal community-based cohort study to date of diverse Hispanic/Latino persons in the United States. The HCHS/SOL aimed to address the dearth of comprehensive data on risk factors for cardiovascular disease (CVD) and other chronic diseases in this population and has expanded considerably in scope since its inception. This paper describes the aims/objectives and data collection of the HCHS/SOL and its ancillary studies to date and highlights the critical and sizable contributions made by the study to understanding the prevalence of and changes in CVD risk/protective factors and the burden of CVD and related chronic conditions among adults of diverse Hispanic/Latino backgrounds. The continued follow-up of this cohort will allow in-depth investigations on cardiovascular and pulmonary outcomes in this population, and data from the ongoing ancillary studies will facilitate generation of new hypotheses and study questions.
Collapse
Affiliation(s)
- Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA.
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Marston E Youngblood
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - M Larissa Avilés-Santa
- Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Hector M González
- Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - John Kunz
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James P Lash
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Carlos J Rodriguez
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
| |
Collapse
|
8
|
Lamar M, Estrella ML, Capuano AW, Leurgans S, Fleischman DA, Barnes LL, Lange‐Maia BS, Bennett DA, Marquez DX. A Longitudinal Study of Acculturation in Context and Cardiovascular Health and Their Effects on Cognition Among Older Latino Adults. J Am Heart Assoc 2023; 12:e027620. [PMID: 36926993 PMCID: PMC10111521 DOI: 10.1161/jaha.122.027620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/23/2023] [Indexed: 03/18/2023]
Abstract
Background We previously outlined the importance of considering acculturation within the context of older Latino adults' lived experience (ie, acculturation in context) to better capture contributors to cognitive aging. We now examine this conceptual framework as related to level of and change in cardiovascular health, and whether cardiovascular health modifies previously documented associations of acculturation in context with cognition. Methods and Results Acculturation in context data from 192 Latino participants without dementia at baseline (age ~70 years) were compiled into 3 separate composite scores: acculturation-related (nativity, language-, and social-based preferences), contextually related socioenvironmental (experiences of discrimination, social isolation, social networks), and familism-related (Latino-centric family ethos). A modified American Heart Association's Life's Simple 7 (mLS7; ie, smoking, physical activity, body mass index, blood pressure, total cholesterol, blood glucose) was used to measure cardiovascular health. Mixed effects regressions simultaneously tested the association of all 3 composite scores with total mLS7 adjusting for confounders. Separate models tested whether mLS7 modified associations of the 3 composite scores and cognition. The contextually related socioenvironmental composite score reflecting higher discrimination, higher social isolation, and smaller social networks (estimate=0.22, SE=0.10, P=0.02) and the familism score (estimate=0.16, SE=0.07, P=0.02) both significantly associated with change in total mLS7. The acculturation-related composite was not significantly associated with change in mLS7. No composite was significantly associated with level of mLS7. Total mLS7, however, significantly modified associations between the acculturation-related composite and change in working memory (estimate=-0.02, SE=0.01, P=0.043). Conclusions Acculturation within the context of older Latino adults' lived experience is important for maintaining cardiovascular health, relationships that also affect domain-specific cognitive decline.
Collapse
Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIL
| | - Mayra L. Estrella
- Department of Epidemiology, Human Genetics and Environmental SciencesUniversity of Texas Health Science Center at Houston School of Public HealthBrownsvilleTX
| | - Ana W. Capuano
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Sue Leurgans
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Debra A. Fleischman
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - Brittney S. Lange‐Maia
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Preventive MedicineRush University Medical CenterChicagoIL
| | - David A. Bennett
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Neurological SciencesRush University Medical CenterChicagoIL
| | - David X. Marquez
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
- Department of Kinesiology and NutritionUniversity of Illinois ChicagoChicagoIL
| |
Collapse
|
9
|
Dingle SE, Bujtor MS, Milte CM, Bowe SJ, Daly RM, Torres SJ. Statistical Approaches for the Analysis of Combined Health-Related Factors in Association with Adult Cognitive Outcomes: A Scoping Review. J Alzheimers Dis 2023; 92:1147-1171. [PMID: 36872778 DOI: 10.3233/jad-221034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUND Dementia prevention is a global health priority, and there is emerging evidence to support associations between individual modifiable health behaviors and cognitive function and dementia risk. However, a key property of these behaviors is they often co-occur or cluster, highlighting the importance of examining them in combination. OBJECTIVE To identify and characterize the statistical approaches used to aggregate multiple health-related behaviors/modifiable risk factors and assess associations with cognitive outcomes in adults. METHODS Eight electronic databases were searched to identify observational studies exploring the association between two or more aggregated health-related behaviors and cognitive outcomes in adults. RESULTS Sixty-two articles were included in this review. Fifty articles employed co-occurrence approaches alone to aggregate health behaviors/other modifiable risk factors, eight studies used solely clustering-based approaches, and four studies used a combination of both. Co-occurrence methods include additive index-based approaches and presenting specific health combinations, and whilst simple to construct and interpret, do not consider the underlying associations between co-occurring behaviors/risk factors. Clustering-based approaches do focus on underlying associations, and further work in this area may aid in identifying at-risk subgroups and understanding specific combinations of health-related behaviors/risk factors of particular importance in the scope of cognitive function and neurocognitive decline. CONCLUSION A co-occurrence approach to aggregating health-related behaviors/risk factors and exploring associations with adult cognitive outcomes has been the predominant statistic approach used to date, with a lack of research employing more advanced statistical methods to explore clustering-based approaches.
Collapse
Affiliation(s)
- Sara E Dingle
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Melissa S Bujtor
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia.,Department of Psychological Medicine, Stress, Psychiatry and Immunology Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Steven J Bowe
- Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.,Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Robin M Daly
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| |
Collapse
|
10
|
Zhao YL, Ou YN, Ma YH, Huang YY, Bi YL, Tan L, Yu JT. Association between Life’s Simple 7 and cerebrospinal fluid biomarkers of Alzheimer’s disease pathology in cognitively intact adults: the CABLE study. Alzheimers Res Ther 2022; 14:74. [PMID: 35619174 PMCID: PMC9134665 DOI: 10.1186/s13195-022-01019-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/16/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Introduction
This study sought to explore the association between Life’s Simple 7 (LS7) and cerebrospinal fluid (CSF) Alzheimer’s disease (AD) pathological biomarkers in the cognitively normal northern Chinese population.
Methods
From the Chinese Alzheimer’s Biomarker and LifestylE (CABLE) study, 1106 cognitively normal participants were enrolled. The mean age was 62.34 years, and 39.6% were female. LS7 scores were summed with each metric assigned 0, 1, or 2 scores. The multiple linear regression models were used to investigate the association between LS7 scores and CSF AD biomarkers.
Results
We found that LS7 scores were significantly associated with CSF AD pathologies, including Aβ42/40 (β = 0.034, P = .041), p-tau181 (β = − 0.043, P = .006), and t-tau (β = − 0.044, P = .003). In subscales, the biological metrics (blood pressure, cholesterol, glucose) were significantly related to CSF tau-related biomarkers. These associations were observed in the APOE ε4 allele non-carriers, yet not in carriers. The relationship of behavior metrics was found in the middle age and males.
Conclusion
Improving LS7 scores might do a favor to alleviate the pathology of AD in the preclinical stage, especially among the APOE ε4 allele non-carriers.
Collapse
|
11
|
Vásquez PM, Tarraf W, Li Y, Jenkins D, Soria-Lopez J, Zlatar ZZ, Marquine MJ, Stickel AM, Estrella ML, Gallo LC, Lipton RB, Isasi CR, Cai J, Zeng D, Daviglus ML, Schneiderman N, González HM. Concordance Between Self-Reported Medical Diagnosis of Mild Cognitive Impairment/Dementia and Neurocognitive Function Among Middle-Aged and Older Hispanic/Latino Adults: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). J Alzheimers Dis 2022; 88:45-55. [PMID: 35599477 DOI: 10.3233/jad-215060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Population-based studies typically rely on self-reported medical diagnosis (SRMD) of mild cognitive impairment (MCI)/dementia; however, links to objective neurocognitive function have not been established. Objective: Examine the association between SRMD of MCI/dementia and objective neurocognitive function among Hispanic/Latino adults. Methods: We conducted a case-control study using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) baseline data and its ancillary SOL-Investigation of Neurocognitive Aging (SOL-INCA) at visit 2. Hispanic/Latino adults aged 50 years and older (n = 593) were administered neurocognitive tests: the Six-Item Screener (SIS), Brief-Spanish English Verbal Learning Test (B-SVELT Sum), B-SVELT Recall, Word Fluency Test (WF), Digit Symbol Substitution Test (DSS), and Trail Making Test A and B. Individual and global neurocognitive function scores were used for analyses. Propensity matching techniques and survey generalized linear regression models were used to compare SRMD of MCI/dementia with demographic, psychological, and cardiovascular risk matched controls. Complex survey design methods were applied. Results: There were 121 cases of SRMD of MCI/dementia and 472 propensity matched controls. At baseline, compared to matched controls, cases showed no differences in neurocognitive function (p > 0.05). At SOL-INCA visit 2, cases had poorer scores in global neurocognitive function (p < 0.05), B-SEVLT Sum, B-SEVLT Recall, WF, DSS, and Trail A (p < 0.01). Conclusion: Observed differences in neurocognitive test scores between SRMD of MCI/dementia cases and matched controls were present at visit 2, but not at baseline in middle-aged and older Hispanic/Latino adults. These findings present initial evidence of the potential utility of SRMD of MCI/dementia in epidemiologic studies, where obtaining confirmation of diagnosis may not be feasible.
Collapse
Affiliation(s)
- Priscilla M. Vásquez
- Charles R. Drew University of Medicine and Science, Department of Urban Public Health, Los Angeles, CA, USA
| | - Wassim Tarraf
- Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Yuyi Li
- Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Derek Jenkins
- Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Jose Soria-Lopez
- University of California San Diego, Department of Neurosciences, La Jolla, CA, USA
| | - Zvinka Z. Zlatar
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Maria J. Marquine
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- University of California San Diego, Department of Medicine, La Jolla, CA, USA
| | - Ariana M. Stickel
- University of California San Diego, Department of Neurosciences, La Jolla, CA, USA
| | - Mayra L. Estrella
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago, IL, USA
| | - Linda C. Gallo
- San Diego State University, Department of Psychology, San Diego, CA, USA
| | - Richard B. Lipton
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, Bronx, NY, USA
| | - Carmen R. Isasi
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, Bronx, NY, USA
| | - Jianwei Cai
- University of North Carolina at Chapel Hill, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Dongling Zeng
- University of North Carolina at Chapel Hill, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Martha L. Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago, IL, USA
| | - Neil Schneiderman
- University of Miami, Department of Psychology, Coral Gables, FL, USA
| | - Hector M. González
- University of California San Diego, Department of Neurosciences, La Jolla, CA, USA
| |
Collapse
|
12
|
Gui Z, Cai L, Lv Y, Lai L, Zeng X, Chen Y. Association Between Ideal Cardiovascular Health and Executive Function in Chinese Primary School Children. Front Public Health 2022; 9:736424. [PMID: 35096728 PMCID: PMC8790157 DOI: 10.3389/fpubh.2021.736424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: Little information exists on the associations of cardiovascular health, a new metric proposed by the American Heart Association, and executive function, particularly in children. We aimed to explore this topic. Methods: We studied 3,798 children aged 6–12 years from 5 schools in Guangzhou, China. The executive function of children was evaluated using parent reports of the Behavioral Rating Inventory of Executive Function, which included 2 composite indexes and 8 subscale scores. We calculated the number of ideal cardiovascular health (range: 0–7) based on smoking, body mass index, physical activity (PA), diet, blood pressure, cholesterol, and glucose. A generalized linear mixed model was used to assess the association of the number of ideal cardiovascular health metrics and executive function. Results: Compared with children exhibiting 1–3 ideal cardiovascular health metrics, decreases of 1.37–2.63 points (indicating better performance) in metacognition index and its 5 subscale indexes (initiate, working memory, plan/organize, organization of materials, and monitor) were observed in children who attained 5 or 6–7 ideal metrics (all p for trend <0.001). Ideal diet and ideal PA were independently associated with lower indexes of behavioral regulation and metacognition. Conclusions: The number of ideal cardiovascular health was positively associated with performance of executive function in children.
Collapse
Affiliation(s)
- Zhaohuan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yajie Lv
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lijuan Lai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xia Zeng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
13
|
Wei J, Wang L, Kulshreshtha A, Xu H. Adherence to Life's Simple 7 and Cognitive Function Among Older Adults: The National Health and Nutrition Examination Survey 2011 to 2014. J Am Heart Assoc 2022; 11:e022959. [PMID: 35243896 PMCID: PMC9075323 DOI: 10.1161/jaha.121.022959] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The American Heart Association proposed the Life’s Simple 7 (LS7; including diet, physical activity, smoking, body mass index, blood pressure, plasma fasting glucose, total cholesterol) to promote cardiovascular health. Adherence to LS7 has been found to be associated with better cognitive health as well, but the generalizability of previous studies is limited. We aimed to examine the associations of adherence to LS7 and cognitive function among older adults in a nationally representative sample of population. Methods and Results A total of 2585 older adults (≥60 years, 54% female, 80% non‐Hispanic White) in the National Health and Nutrition Examination Survey 2011 to 2014 were included for analysis. Components of LS7 were measured, and adherence to LS7 was calculated on the basis of established cutoff points of individual components. Cognitive function was examined using the Consortium to Establish a Registry for Alzheimer’s Disease Word List Memory Task (immediate and delayed memory), Digit Symbol Substitution Test (DSST), and Animal Fluency Test. Test‐specific and global cognition Z scores were created. Multivariable linear regression models were conducted on the associations of adherence to LS7 with domain‐specific and global cognition Z scores. Each incremental point in adherence to LS7 was associated with higher Z scores for global cognition (β=0.05; 95% CI, 0.02–0.07), Digit Symbol Substitution Test (β=0.05; 95% CI, 0.03–0.07), Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest immediate memory (β=0.03; 95% CI, 0.004–0.05), and animal fluency test (β=0.05; 95% CI, 0.02–0.07). Conclusions Greater adherence to LS7 metrics is associated with better cognitive function among older US adults in a nationally representative sample of population.
Collapse
Affiliation(s)
- Jingkai Wei
- Department of Epidemiology and Biostatistics Arnold School of Public Health University of South Carolina Columbia SC
| | - Liang Wang
- Department of Public Health Robbins College of Health and Human SciencesBaylor University Waco TX
| | - Ambar Kulshreshtha
- Department of Family and Preventive Medicine School of Medicine Emory University Atlanta GA.,Department of Epidemiology Rollins School of Public Health Atlanta GA
| | - Hanzhang Xu
- School of Nursing Duke University Durham NC.,Department of Family Medicine and Community Health Duke University Medical Center Durham NC
| |
Collapse
|
14
|
Lazar RM, Howard VJ, Kernan WN, Aparicio HJ, Levine DA, Viera AJ, Jordan LC, Nyenhuis DL, Possin KL, Sorond FA, White CL. A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association. Stroke 2021; 52:e295-e308. [PMID: 33719523 PMCID: PMC8995075 DOI: 10.1161/str.0000000000000367] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A healthy brain is critical for living a longer and fuller life. The projected aging of the population, however, raises new challenges in maintaining quality of life. As we age, there is increasing compromise of neuronal activity that affects functions such as cognition, also making the brain vulnerable to disease. Once pathology-induced decline begins, few therapeutic options are available. Prevention is therefore paramount, and primary care can play a critical role. The purpose of this American Heart Association scientific statement is to provide an up-to-date summary for primary care providers in the assessment and modification of risk factors at the individual level that maintain brain health and prevent cognitive impairment. Building on the 2017 American Heart Association/American Stroke Association presidential advisory on defining brain health that included "Life's Simple 7," we describe here modifiable risk factors for cognitive decline, including depression, hypertension, physical inactivity, diabetes, obesity, hyperlipidemia, poor diet, smoking, social isolation, excessive alcohol use, sleep disorders, and hearing loss. These risk factors include behaviors, conditions, and lifestyles that can emerge before adulthood and can be routinely identified and managed by primary care clinicians.
Collapse
|
15
|
Tarraf W, Kaplan R, Daviglus M, Gallo LC, Schneiderman N, Penedo FJ, Perreira KM, Lamar M, Chai A, Vásquez PM, González HM. Cardiovascular Risk and Cognitive Function in Middle-Aged and Older Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Alzheimers Dis 2021; 73:103-116. [PMID: 31771064 DOI: 10.3233/jad-190830] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cardiovascular disease is linked to cognitive decline and disorders (e.g., dementia). The evidence is based largely on older non-Latino White cohorts. OBJECTIVE Examine the association between global vascular risk and cognitive function among Hispanics/Latinos in the United States. METHODS We used data from a large sample of stroke- and cardiovascular disease-free, middle-aged and older Hispanics/Latinos with diverse backgrounds (n=7,650) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We compared associations between two measures of cardiovascular risk (CVR), the Framingham Cardiovascular Risk Score (FCRS) and the multiethnic Global Vascular Risk Score (GVRS), and cognitive performance using measures of global and domain specific cognitive function, and tested for modification by sex and age. RESULTS Higher FCRS and GVRS were associated with lower global cognition and higher probability of low mental status, after covariates adjustment. Both CVR indices were associated with lower performances in learning and memory, verbal fluency, and psychomotor speed. Higher GVRS presented stronger associations with lower cognitive function compared to the FCRS. Women and younger age (45-64 years) exhibited more pronounced associations between higher CVR and worse cognition, particularly so with the GVRS. DISCUSSION CVR is also a risk for compromised cognitive function and evident in middle-age among Hispanics/Latinos. The multiethnic GVRS, tailored to specific risks based on racial/ethnic background, is feasible to use in primary care settings and can provide important insight on cognitive risk. Even modest shifts in population toward cardiovascular health in the high-risk Hispanic/Latino population can have important positive impacts on healthy cognitive aging.
Collapse
Affiliation(s)
- Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | | | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Frank J Penedo
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Krista M Perreira
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA.,Department of Psychiatry & Behavioral Sciences and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Albert Chai
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
| | - Priscilla M Vásquez
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, CA, USA
| |
Collapse
|
16
|
Alam MT, Echeverria SE, DuPont-Reyes MJ, Vasquez E, Murillo R, Gonzalez T, Rodriguez F. Educational Attainment and Prevalence of Cardiovascular Health (Life's Simple 7) in Asian Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041480. [PMID: 33557415 PMCID: PMC7914420 DOI: 10.3390/ijerph18041480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022]
Abstract
Asian Americans have a high burden of cardiovascular disease, yet little is known about the social patterning of cardiovascular health (CVH) in this population. We examined if education (<high school diploma, high school diploma, some college, and college degree+) was associated with CVH and if this varied by time in the United States (U.S.). Our study population included Asian Americans 20+ years of age sampled in the 2011-16 National Health and Nutrition Examination Survey (n = 1634). Ideal cardiovascular health was based on a composite score of adiposity, total cholesterol, blood pressure, blood glucose, smoking, physical activity, and diet. We fit sequential weighted multivariate logistic regression models for all analyses. The prevalence of ideal cardiovascular (CV) health was 17.1% among those living in the U.S. <10 years, 7.1% for those living in the U.S. >10+ years, and 15.9% for the U.S.-born. All models showed that low education compared to high education was associated with lower odds of having ideal CVH. This pattern remained in adjusted models but became non-significant when controlling for nativity (odds ratio = 0.34, 95% confidence interval: 0.10, 1.13). Models stratified by time in the U.S. were less consistent but showed similar education gradients in CVH. Low education is a risk factor for attaining ideal cardiovascular health among Asian Americans, regardless of time in the U.S.
Collapse
Affiliation(s)
- Md Towfiqul Alam
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
- Correspondence:
| | - Sandra E. Echeverria
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Melissa J. DuPont-Reyes
- Department of Epidemiology & Biostatistics, Texas A&M University, College Station, TX 77843, USA;
| | - Elizabeth Vasquez
- Department of Epidemiology & Biostatistics, University at Albany, Albany, NY 12144, USA;
| | - Rosenda Murillo
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX 77204, USA;
| | - Tailisha Gonzalez
- Department of Community Health, CUNY Graduate School of Public Health & Health Policy, New York, NY 10027, USA;
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine, Stanford University, Quarry Road, Falk CVRC, Stanford, CA 94305, USA;
| |
Collapse
|
17
|
Estrella ML, Durazo-Arvizu RA, Gallo LC, Tarraf W, Isasi CR, Perreira KM, Zeng D, Marquine MJ, Lipton RB, González HM, Daviglus ML, Lamar M. Psychosocial Factors Associated with Cognitive Function Among Middle-Aged and Older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos and its Sociocultural Ancillary Study. J Alzheimers Dis 2020; 79:433-449. [PMID: 33285630 DOI: 10.3233/jad-200612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Evidence suggests that psychosocial factors are associated with cognitive health in older adults; however, associations of psychosocial factors with cognition remain largely unexamined in middle-aged and older Hispanics/Latinos. OBJECTIVE To examine the cross-sectional associations of psychosocial factors with cognitive function among middle-aged and older Hispanics/Latinos living in the US. METHODS Baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 2,818; ages 45-74) were used to examine the associations of each psychosocial factor with global cognition (GC), verbal learning, verbal memory, verbal fluency, and processing speed independent of age, sex, education, Hispanic/Latino background, income, language, and depressive symptoms. Psychosocial variables included: intrapersonal factors (ethnic identity, optimism, and purpose in life), interpersonal factors (family cohesion, familism, social network embeddedness, and social support), and social stressors (perceived ethnic discrimination, loneliness, and subjective social status). RESULTS In fully-adjusted models, purpose in life and social support were each positively associated with all five cognitive variables. Loneliness was negatively associated with GC, verbal learning, memory, and processing speed. Ethnic identity was positively and familism negatively associated with GC, verbal fluency, and processing speed. Family cohesion was positively associated with verbal learning. CONCLUSION These findings extend previous evidence from older, largely non-Hispanic White cohorts to show that higher purpose in life and social support are also strongly associated with cognitive health among middle-aged and older Hispanics/Latinos. We also highlight that intrapersonal factors, interpersonal factors, and social stressors have differential relationships with individual cognitive tests.
Collapse
Affiliation(s)
- Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donglin Zeng
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maria J Marquine
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Department of Psychiatry and Behavioral Sciences and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
18
|
Lamar M, León A, Romo K, Durazo-Arvizu RA, Sachdeva S, Lipton RB, Perreira KM, Gallo LC, Cai J, Khambaty T, Carrasco J, Llabre MM, Eyler LT, Daviglus ML, González HM. The Independent and Interactive Associations of Bilingualism and Sex on Cognitive Performance in Hispanics/Latinos of the Hispanic Community Health Study/Study of Latinos. J Alzheimers Dis 2020; 71:1271-1283. [PMID: 31524155 DOI: 10.3233/jad-190019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sixty percent of Hispanics/Latinos are bilingual which research suggests may confer certain cognitive advantages. Female sex confers cognitive advantages in verbal learning and memory compared to male sex, regardless of race or ethnicity. Understanding the independent and interactive associations of bilingualism and sex with cognition may aid in predicting cognitive aging in Hispanics/Latinos. We examined baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos, a multicenter, prospective community-based study. Our analyses included 6,110 males and females ≥45 years old who self-reported birth and parents' origin outside of the continental US, Spanish as their first language, and were evaluated in Spanish. Bilingualism was assessed along a Likert scale (1 = only Spanish to 4 = English>Spanish) for language proficiency (reading/spoken) and patterns of use (thinking/socializing). Cognitive testing included verbal learning, memory, fluency, and Digit Symbol Substitution (DSS). Linear regression models adjusted for relevant confounders, the complex survey design, and sampling weights. Participants' self-reported language proficiency was Spanish better than English, while patterns of use suggested more Spanish than English. Higher language proficiency was associated with higher performance on all cognitive indices while higher patterns of use associated with higher fluency and DSS scores (p-values < 0.01). Female sex was associated with higher performance on all cognitive indices (p-values < 0.05). There were no significant interactions with bilingualism (regardless of metric) by sex on cognition. For Hispanics/Latinos residing in the continental US and reporting birth and parents' origin elsewhere, bilingualism and female sex have independent cognitive benefits that are important to consider when evaluating cognitive performance.
Collapse
Affiliation(s)
- Melissa Lamar
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Adeline León
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Karina Romo
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ramon A Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA.,Department of Public Health Sciences, Loyola University, Chicago, IL, USA
| | - Shruti Sachdeva
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC, USA
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County (UMBC), Baltimore, MD, USA
| | - Jessica Carrasco
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Martha L Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Hector M González
- Department of Neuroscience, Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA, USA
| |
Collapse
|
19
|
Kulshreshtha A, Goetz M, Alonso A, Shah AJ, Bremner JD, Goldberg J, Vaccarino V. Association Between Cardiovascular Health and Cognitive Performance: A Twins Study. J Alzheimers Dis 2020; 71:957-968. [PMID: 31476151 PMCID: PMC6918828 DOI: 10.3233/jad-190217] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVE The 2020 Strategic Impact Goal introduced by the American Heart Association (AHA) aims at improving cardiovascular health (CVH) of all Americans by 20%. AHA defined ideal CVH across seven established modifiable risk factors for cardiovascular diseases. Prior studies have indicated that ideal CVH also benefits brain health and cognitive aging, but it is possible that this association is explained by familial factors. METHODS We examined 272 male monozygotic and dizygotic twin pairs (total 544 subjects) free of overt cardiovascular disease and dementia from the Vietnam Era Twin Registry. Memory and learning were measured by Trail Making tests and Wechsler Memory Scale (Immediate and Delayed Memory tests and Visual Reproductive Test). Each of the seven CVH components (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was scored per established criterion. RESULTS The mean age of the twins was 55 years, 96% were whites, and 61% monozygotic. When considering twins as individuals, for every unit increase in CVH score (indicating better cardiovascular health), twins demonstrated faster cognitive processing speed (Trail B: - 5.6 s, 95% CI - 10.3, - 0.9; p = 0.03) and better story recall, both immediate (0.35, 95% CI 0.06, 0.62; p = 0.02) and delayed (0.39, 95% CI 0.08, 0.70; p = 0.01). CONCLUSIONS Better CVH is associated with better cognitive health in several domains. As suggested by within-pair analysis, this association is largely explained by familial factors, implying that early life exposures are shared determinants of both brain health and cardiovascular health.
Collapse
Affiliation(s)
- Ambar Kulshreshtha
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Margarethe Goetz
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - J Douglas Bremner
- Department of Psychiatry and Behavioral Sciences and the Department of Radiology, Emory University School of Medicine, and the Atlanta VA Medical Center, Decatur, GA, USA
| | - Jack Goldberg
- Vietnam Era Twin Registry, Seattle, WA, USA.,University of Washington School of Public Health, Seattle, WA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
20
|
Suemoto CK, Szlejf C, Santos IS, Brunoni AR, Goulart AC, Bertola L, Bittencourt MS, Viana MC, Barreto SM, Lotufo PA, Bensenor IM. Ideal vascular health and cognitive performance in the Brazilian Longitudinal Study of Adult Health. Eur J Neurol 2020; 28:71-80. [PMID: 32920963 DOI: 10.1111/ene.14532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Most evidence for the association between ideal vascular health (IVH) and cognitive performance comes from high income countries. The aim was to investigate this association in the Brazilian Longitudinal Study of Adult Health. METHODS Cognition was assessed using the word list, verbal fluency and trail making tests. The IVH score included ideal metrics for body mass index, smoking, physical activity, diet, blood pressure, fasting glucose and total cholesterol. Poor, intermediate and optimal health were characterized in those presenting 0-2, 3-4, 5-7 ideal metrics, respectively. To determine the association between IVH score and cognitive performance, linear regression models adjusted for age, sex, education, race, alcohol use, depression and thyroid function were used. RESULTS In 12 271 participants, the mean age was 51.3 ± 8.9 years, 54% were women, 57% White and 53% had poor vascular health. Participants with intermediate (β = 0.064, 95% confidence interval 0.033; 0.096) and optimal health (β = 0.108, 95% confidence interval 0.052; 0.164) had better global cognitive Z-scores. In addition, interactions of IVH score with age, education and race were found, suggesting a better cognitive performance with higher IVH in older adults, Black/Brown participants and those with lower levels of education. CONCLUSION Ideal vascular health was associated with better cognitive performance. Older, Black/Brown and low-educated participants had better cognition in the presence of higher IVH scores.
Collapse
Affiliation(s)
| | - C Szlejf
- University of São Paulo, São Paulo, Brazil
| | - I S Santos
- University of São Paulo, São Paulo, Brazil
| | | | | | - L Bertola
- University of São Paulo, São Paulo, Brazil
| | | | - M C Viana
- Federal University of Espirito Santo, Espirito Santo, Brazil
| | - S M Barreto
- Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - P A Lotufo
- University of São Paulo, São Paulo, Brazil
| | | |
Collapse
|
21
|
Lamar M, Durazo-Arvizu RA, Rodriguez CJ, Kaplan RC, Perera MJ, Cai J, Espinoza Giacinto RA, González HM, Daviglus ML. Associations of Lipid Levels and Cognition: Findings from the Hispanic Community Health Study/Study of Latinos. J Int Neuropsychol Soc 2020; 26:251-262. [PMID: 31543086 PMCID: PMC7083682 DOI: 10.1017/s1355617719001000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Hispanics/Latinos in the United States are less aware of their cholesterol levels and have a higher burden of associated adverse cardiovascular and cerebrovascular outcomes than non-Latino whites. Investigations of the associations between cholesterol levels and cognition in this population have often occurred within the context of metabolic syndrome and are limited to select lipids despite the fact that triglycerides (TGs) may be more relevant to the health of Hispanics/Latinos. METHODS Baseline data from the Hispanic Community Health Study/Study of Latinos, collected from 2008 to 2011, was used to investigate the associations of lipid levels (i.e., TG, total cholesterol, TC; low-density and high-density lipoprotein cholesterol, LDL-C and HDL-C) with cognition (i.e., learning, memory, verbal fluency, and digit symbol substitution, DSS), adjusting for relevant confounders. RESULTS In 7413 participants ages 45 to 74 years from Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American backgrounds, separate, fully adjusted linear regression models revealed that TG levels were inversely associated with DSS performance; however, this relationship was no longer significant once additional cardiovascular disease risk factors were added to the model (p = .06). TC and LDL-C levels (separately) were positively associated with learning and verbal fluency regardless of adjustments (p-values < .05). Separate analyses investigating the effect modification by background and sex revealed a particularly robust association between TC levels and DSS performance for Puerto Ricans and Central Americans (albeit in opposite directions) and an inverse relationship between TG levels and DSS performance for women (p-values < .02). CONCLUSIONS It is important to consider individual lipid levels and demographic characteristics when investigating associations between cholesterol levels and cognition in Hispanics/Latinos.
Collapse
Affiliation(s)
- Melissa Lamar
- Department of Medicine, University of Illinois at Chicago, Chicago, IL
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
- Rush Alzheimer’s Disease Center and Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
- Department of Public Health Sciences, Loyola University, Chicago, IL
| | - Carlos J. Rodriguez
- Department of Epidemiology & Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA 98109
| | | | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC
| | - Rebeca A. Espinoza Giacinto
- Department of Psychology, University of California San Diego, San Diego, CA
- Division of Health Promotion and Behavioral Sciences, University of California San Diego, San Diego, CA
| | - Hector M. González
- Department of Neuroscience, Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, CA
| | - Martha L. Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, IL
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
| |
Collapse
|
22
|
|
23
|
Perales-Puchalt J, Vidoni ML, Rodríguez JL, Vidoni ED, Billinger S, Burns J, Guerchet M, Lee M. Cardiovascular health and dementia incidence among older adults in Latin America: Results from the 10/66 study. Int J Geriatr Psychiatry 2019; 34:1041-1049. [PMID: 30908765 PMCID: PMC6579616 DOI: 10.1002/gps.5107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/17/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. This study aimed to assess the longitudinal association between CVH and dementia in six Latin American countries. METHODS We analyzed longitudinal data from the 10/66 study that included nondementia residents at baseline aged 65+ in six Latin American countries (n = 6447) and were followed up for 3 years. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risk regression to adjust for risk of death. RESULTS The sample included 6.2% participants with poor (0-5), 81.0% with moderate (6-10), and 12.8% with ideal CVH (11-14). At follow-up, 9.4% had developed dementia and 13.1% had died. Compared with those with poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia in both the unadjusted (subhazard ratio for moderate, 0.77; ideal, 0.59) and adjusted models (moderate, 0.73; ideal, 0.66). CONCLUSION Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries.
Collapse
Affiliation(s)
| | | | - Juan Llibre Rodríguez
- Facultad de Medicina Finley-Albarrán, Universidad de Ciencias Médicas de la Habana, Habana, 11500, Cuba
| | - Eric D Vidoni
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA
| | - Sandra Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Jeffrey Burns
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA
| | - Maëlenn Guerchet
- King’s College London, Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, United Kingdom
| | - MinJae Lee
- The University of Texas Health Science Center at Houston, McGovern Medical School; Houston, TX 77030, USA
| |
Collapse
|
24
|
Differences in Cardiovascular Health Metrics in Emergency Medical Technicians Compared to Paramedics: A Cross-Sectional Study of Emergency Medical Services Professionals. Prehosp Disaster Med 2019; 34:288-296. [DOI: 10.1017/s1049023x19004254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Emergency Medical Services (EMS) professionals face high physical demands in high-stress settings; however, the prevalence of cardiovascular health (CVH) risk factors in this health care workforce has not been explored. The primary objective of this study was to compare the distribution of CVH and its individual components between a sample of emergency medical technicians (EMTs) and paramedics. The secondary objective was to identify associations between demographic and employment characteristics with ideal CVH in EMS professionals.Methods:A cross-sectional survey based on the American Heart Association’s (AHA; Dallas, Texas USA) Life’s Simple 7 (LS7) was administered to nationally-certified EMTs and paramedics. The LS7 components were scored according to previously described cut points (ideal = 2; intermediate = 1; poor = 0). A composite CVH score (0-10) was calculated from the component scores, excluding cholesterol and blood glucose due to missing data. Multivariable logistic regression was used to estimate odds ratios (OR; 95% CI) for demographic and employment characteristics associated with optimal CVH (≥7 points).Results:There were 24,708 respondents that were currently practicing and included. More EMTs achieved optimal CVH (n = 4,889; 48.8%) compared to paramedics (n = 4,338; 40.6%). Factors associated with higher odds of optimal CVH included: higher education level (eg, college graduate or more: OR = 2.26; 95% CI, 1.97-2.59); higher personal income (OR = 1.26; 95% CI, 1.17-1.37); and working in an urban versus rural area (OR = 1.31; 95% CI, 1.23-1.40). Paramedic certification level (OR = 0.84; 95% CI, 0.78-0.91), older age (eg, 50 years or older: OR = 0.65; 95% CI, 0.58-0.73), male sex (OR = 0.54; 95% CI, 0.50-0.56), working for a non-fire-based agency (eg, private service: OR = 0.68; 95% CI, 0.62-0.74), and providing medical transport service (OR = 0.81; 95% CI, 0.69-0.94) were associated with lower odds of optimal CVH.Conclusions:Several EMS-related characteristics were associated with lower odds of optimal CVH. Future studies should focus on better understanding the CVH and metabolic risk profiles for EMS professionals and their association with incident cardiovascular disease (CVD), major cardiac events, and occupational mortality.Cash RE, Crowe RP, Bower JK, Foraker RE, Panchal AR. Differences in cardiovascular health metrics in emergency medical technicians compared to paramedics: a crosssectional study of Emergency Medical Services professionals.Prehosp Disaster Med.2019;34(3):288–296.
Collapse
|
25
|
Lamar M, Durazo-Arvizu RA, Sachdeva S, Pirzada A, Perreira KM, Rundek T, Gallo LC, Grober E, DeCarli C, Lipton RB, Tarraf W, González HM, Daviglus ML. Cardiovascular disease risk factor burden and cognition: Implications of ethnic diversity within the Hispanic Community Health Study/Study of Latinos. PLoS One 2019; 14:e0215378. [PMID: 31009492 PMCID: PMC6476505 DOI: 10.1371/journal.pone.0215378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/01/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Hispanics/Latinos have some of the highest prevalence rates for cardiovascular disease risk factors, but stark differences exist by self-reported background. Cardiovascular disease risk factors negatively impact cognition in Hispanics/Latinos; less is known about these relationships by Hispanic/Latino backgrounds. We investigated cognitive associations with cardiovascular disease risk factor burden in a diverse cohort, the Hispanic Community Health Study/Study of Latinos. METHODS Baseline data from this observational study of cardiovascular disease and its antecedents was collected from 2008-2011. We included 7,121 participants 45-74 years old from Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American backgrounds. Dichotomous indicators for hypertension, diabetes, hypercholesterolemia, obesity, and smoking were evaluated and totaled, with participants grouped by lowest (0-2), middle (3) or highest (4-5) burden. Cognitive testing included the Brief Spanish English Verbal Learning Test, letter fluency, and digit symbol substitution. RESULTS In separate fully-adjusted linear regression models, lower fluency and digit symbol substitution performance were restricted to the highest compared to the lowest burden group; whereas the middle burden group displayed impaired memory performance compared to the lowest burden group (p-values≤0.05). Background interacted with burden for learning and memory performance. That is, the association of burden level (i.e., lowest, middle, or highest) with cognitive performance was modified by background (e.g., Mexicans vs Cuban). CONCLUSIONS Hispanics/Latinos with higher levels of cardiovascular disease risk factor burden displayed lower levels of cognitive performance, with learning and memory performance modified by background.
Collapse
Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease Center and the Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Public Health Sciences, Loyola University, Chicago, Illinois, United States of America
| | - Shruti Sachdeva
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Krista M. Perreira
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Tatjana Rundek
- Department of Neurology, University of Miami Health System, Miami, Florida, United States of America
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California, United States of America
| | - Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Charles DeCarli
- Department of Neurology, University of California Davis Health System, Sacramento, California, United States of America
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan, United States of America
| | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, California, United States of America
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| |
Collapse
|
26
|
Cardiovascular health and cognitive function among Mexican older adults: cross-sectional results from the WHO Study on Global Ageing and Adult Health. Int Psychogeriatr 2018; 30:1827-1836. [PMID: 29667567 PMCID: PMC6193870 DOI: 10.1017/s1041610218000297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
UNLABELLED ABSTRACTObjectives:To assess the association between cardiovascular health and cognitive function among Mexican older adults. DESIGN Nationally representative cross-sectional survey. SETTING Households in Mexico. PARTICIPANTS Individuals aged 50 years and older (n = 1,492) from the Mexico-SAGE project Wave 1. MEASUREMENTS A continuous and a categorical index of cardiovascular health was calculated based on exercise, smoking, body mass index, and blood pressure ranging from 0 to 4. Cognitive function was obtained by averaging the standardized scores (z scores) of five psychometric tests. Associations were conducted using linear regression. RESULTS The continuous index of cardiovascular health was not associated with cognitive function. Using the categorical index, participants with the best levels of cardiovascular (score of 4) health performed better on global cognitive function than groups with lower cardiovascular health (scores of 0, 0.41 SD; 1, 0.39 SD; and 2, 0.56 SD). The association was moderated by age, reaching significance only among those 50-64 years old. CONCLUSIONS If longitudinal research confirms these findings, results would suggest that dementia-related policies in Mexico need to focus on achieving optimal levels of cardiovascular health, especially in midlife.
Collapse
|
27
|
Gardener H, Caunca M, Dong C, Cheung YK, Alperin N, Rundek T, Elkind MSV, Wright CB, Sacco RL. Ideal Cardiovascular Health and Biomarkers of Subclinical Brain Aging: The Northern Manhattan Study. J Am Heart Assoc 2018; 7:e009544. [PMID: 30369305 PMCID: PMC6201403 DOI: 10.1161/jaha.118.009544] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/09/2018] [Indexed: 12/19/2022]
Abstract
Background The American Heart Association Life's Simple 7 metric defines ideal cardiovascular health (CVH) on 7 factors: smoking, diet, physical activity, body mass index, blood sugar, blood pressure, and cholesterol. This metric has been used to define optimal brain health, but data relative to subclinical imaging biomarkers of brain aging are lacking. This study examines the association between Life's Simple 7 with white matter hyperintensity volume, silent brain infarcts, and cerebral volume. Methods and Results A subsample of stroke-free participants from the population-based Northern Manhattan Study underwent brain magnetic resonance imaging an average of 7 years after baseline. Linear and logistic regression models were constructed to estimate associations between the number of ideal CVH metrics achieved with imaging biomarkers of brain aging, adjusting for sociodemographics. Among 1031 participants (mean age at magnetic resonance imaging=72±8, 40% men, 19% black, 16% white, and 65% Hispanic), no one had ideal status in all 7 factors, 1% had ideal status in 6 factors, 18% in 4 to 5 factors, 30% in 3 factors, 33% in 2 factors, and 18% in 0 to 1 factors. The number of ideal CVH factors achieved was inversely associated with white matter hyperintensity volume (beta per factor=-0.047; P=0.04) and silent brain infarct (odds ratio per factor=0.84; 95% confidence interval=0.72-0.97) and positively associated with cerebral volume (beta per factor=0.300; P=0.002). Conclusions An increasing ideal CVH score was associated with less white matter hyperintensity volume and silent brain infarcts and greater cerebral volumes, supporting the Life's Simple 7 metric as a useful measure to quantify optimal brain health. Monitoring and promoting achievement of Life's Simple 7 ideal CVH factors may improve subclinical and clinical brain health outcomes.
Collapse
Affiliation(s)
- Hannah Gardener
- Department of NeurologyUniversity of MiamiMiller School of MedicineMiamiFL
- Evelyn F. McKnight Brain InstituteUniversity of MiamiMiller School of MedicineMiamiFL
| | - Michelle Caunca
- Department of NeurologyUniversity of MiamiMiller School of MedicineMiamiFL
| | - Chuanhui Dong
- Department of NeurologyUniversity of MiamiMiller School of MedicineMiamiFL
- Evelyn F. McKnight Brain InstituteUniversity of MiamiMiller School of MedicineMiamiFL
| | - Ying Kuen Cheung
- Department of BiostatisticsMailman Public School of HealthColumbia UniversityNew YorkNY
| | - Noam Alperin
- Department of NeurologyUniversity of MiamiMiller School of MedicineMiamiFL
- Evelyn F. McKnight Brain InstituteUniversity of MiamiMiller School of MedicineMiamiFL
| | - Tatjana Rundek
- Department of NeurologyUniversity of MiamiMiller School of MedicineMiamiFL
- Evelyn F. McKnight Brain InstituteUniversity of MiamiMiller School of MedicineMiamiFL
| | - Mitchell S. V. Elkind
- Department of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNY
| | | | - Ralph L. Sacco
- Department of NeurologyUniversity of MiamiMiller School of MedicineMiamiFL
- Evelyn F. McKnight Brain InstituteUniversity of MiamiMiller School of MedicineMiamiFL
| |
Collapse
|
28
|
Tsai CK, Kao TW, Lee JT, Wang CC, Chou CH, Liang CS, Yang FC, Chen WL. Global-cognitive health metrics: A novel approach for assessing cognition impairment in adult population. PLoS One 2018; 13:e0197691. [PMID: 29813084 PMCID: PMC5973572 DOI: 10.1371/journal.pone.0197691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/07/2018] [Indexed: 12/27/2022] Open
Abstract
Dementia is the supreme worldwide burden for welfare and the health care system in the 21st century. The early identification and control of the modifiable risk factors of dementia are important. Global-cognitive health (GCH) metrics, encompassing controllable cardiovascular health (CVH) and non-CVH risk factors of dementia, is a newly developed approach to assess the risk of cognitive impairment. The components of ideal GCH metrics includes better education, non-obesity, normal blood pressure, no smoking, no depression, ideal physical activity, good social integration, normal glycated hemoglobin (HbA1c), and normal hearing. This study focuses on the association between ideal GCH metrics and the cognitive function in young adults by investigating the Third Health and Nutrition Examination Survey (NHANES III) database, which has not been reported previously. A total of 1243 participants aged 17 to 39 years were recruited in this study. Cognitive functioning was evaluated by the simple reaction time test (SRTT), symbol-digit substitution test (SDST), and serial digit learning test (SDLT). Participants with significantly higher scores of GCH metrics had better cognitive performance (p for trend <0.01 in three cognitive tests). Moreover, better education, ideal physical activity, good social integration and normal glycated hemoglobin were the optimistic components of ideal GCH metrics associated with better cognitive performance after adjusting for covariates (p < 0.05 in three cognitive tests). These findings emphasize the importance of a preventive strategy for modifiable dementia risk factors to enhance cognitive functioning during adulthood.
Collapse
Affiliation(s)
- Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Sung Liang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
29
|
González HM, Tarraf W, Harrison K, Windham BG, Tingle J, Alonso A, Griswold M, Heiss G, Knopman D, Mosley TH. Midlife cardiovascular health and 20-year cognitive decline: Atherosclerosis Risk in Communities Study results. Alzheimers Dement 2018; 14:579-589. [PMID: 29268079 PMCID: PMC5938099 DOI: 10.1016/j.jalz.2017.11.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 11/03/2017] [Accepted: 11/13/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The aim was to examine associations between midlife cardiovascular health (CVH) and 20-year cognitive decline among blacks and whites. METHODS Midlife CVH metrics (American Heart Association's Life's Simple 7) were calculated and examined in relation to midlife and 20-year change in cognitive function among 13,270 whites and blacks from the Atherosclerosis Risk in Communities Cohort Study. We used linear mixed models to estimate adjusted associations of midlife CVH with midlife cognitive status and change. RESULTS Higher midlife (Life's Simple 7) scores and individual metrics, particularly blood pressure and glucose, were associated with better midlife cognition and reduced 20-year decline. Midlife CVH 20-year neuroprotection was more pronounced among whites than blacks. DISCUSSION Better midlife CVH was associated with higher midlife and reduced decline in cognitive function 20 years later. However, the benefits of midlife CVH on cognition were stronger for whites than for blacks. Our findings suggest that improved midlife CVH may promote enduring cognitive health.
Collapse
Affiliation(s)
- Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA, USA
| | - Wassim Tarraf
- Institute of Gerontology, Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Kimystian Harrison
- School of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA
| | - B Gwen Windham
- Department of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Jonathan Tingle
- Department of Data Science, JD Bower School of Population Health, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael Griswold
- Department of Data Science, JD Bower School of Population Health, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Thomas H Mosley
- Department of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA; Memory Impairment and Neurodegenerative Dementia (MIND) Center, The University of Mississippi Medical Center, Jackson, MS, USA.
| |
Collapse
|
30
|
Association of Cardiac Structure and Function With Neurocognition in Hispanics/Latinos: The Echocardiographic Study of Latinos. Mayo Clin Proc Innov Qual Outcomes 2018; 2:165-175. [PMID: 30225446 PMCID: PMC6124325 DOI: 10.1016/j.mayocpiqo.2018.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective To study the associations of comprehensive measures of cardiac structure and function with multidimensional neurocognitive measures. Patients and Methods The Echocardiographic Study of Latinos is a population-based cohort of Hispanic/Latino adults older than 45 years enrolled from October 1, 2011, through June 30, 2014. Neurocognitive measures included Word Fluency (WF), Brief-Spanish English Verbal Learning Test (B-SEVLT), and Digit Symbol Substitution Test. The B-SEVLT included B-SEVLT-recall and B-SEVLT-sum. Echocardiographic measures included cardiac structure, systolic and diastolic function, and myocardial strain. Multivariable regression models were fit using survey statistics and sampling probabilities. Results A total of 1794 participants (mean age, 56±0.5 years; 56% women) were included in the analysis. In the adjusted model, higher left ventricular mass index was associated with lower B-SEVLT-sum and Digit Symbol Substitution Test scores. Left ventricular systolic dysfunction was associated with lower WF scores. Abnormal left ventricular geometry was associated with lower B-SEVLT-sum scores. Higher relative wall thickness was associated with B-SEVLT-recall and B-SEVLT-sum scores. Mitral annular relaxation velocities were associated with lower B-SEVLT-recall, B-SEVLT-sum, and WF scores. Higher mitral inflow to annular early diastolic velocity ratio was associated with lower B-SEVLT-recall and B-SEVLT-sum scores. Diastolic dysfunction was associated with lower B-SEVLT-sum scores. Finally, lower global longitudinal strain was associated with lower WF scores. Conclusion Alterations in cardiac structure, systolic and diastolic function, and myocardial strain were associated with worse neurocognitive function. Further study is needed to determine the mechanisms (ie, impairment of cerebral flow and silent brain infarctions) mediating these heart-brain associations.
Collapse
Key Words
- B-SEVLT, Brief-Spanish English Verbal Learning Test
- BMI, body mass index
- CVH, cardiovascular health
- DSST, Digit Symbol Substitution Test
- E/e′ ratio, ratio of the early mitral inflow velocity to the mitral annular early diastolic velocity
- ECHO-SOL, Echocardiographic Study of Latinos
- EF, ejection fraction
- GLS, global longitudinal strain
- HCHS/SOL, Hispanic Community Health Study/Study of Latinos
- LA, left atrial
- LAVI, left atrial volume index
- LV, left ventricular
- LVESV, left ventricular end-systolic volume
- LVMI, left ventricular mass index
- RWT, relative wall thickness
- SIS, Six-Item Screener
- S′, peak systolic annular velocity
- WF, Word Fluency
- e′, mitral annular early diastolic velocity
Collapse
|
31
|
Tarraf W, Rodríguez CJ, Daviglus ML, Lamar M, Schneiderman N, Gallo L, Talavera GA, Kaplan RC, Fornage M, Conceicao A, González HM. Blood Pressure and Hispanic/Latino Cognitive Function: Hispanic Community Health Study/Study of Latinos Results. J Alzheimers Dis 2018; 59:31-42. [PMID: 28582859 DOI: 10.3233/jad-170017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hispanics/Latinos are at increased risk for cardiovascular disease and cognitive decline and dementias. High blood pressure (BP) has been implicated in both stroke and dementias. Associations between BP and cognition among diverse Latinos are still unpublished. OBJECTIVE We examined associations between cognition and four BP based measures among diverse Hispanics/Latinos. We hypothesized that higher BP, particularly systolic pressure, and increased arterial stiffness (i.e., pulse pressure), would be associated with lower cognitive function. METHODS We used baseline (2008-2011) Hispanic Community Health Study/Study of Latinos (HCHS/SOL; n = 9,019; ages 45-74 years) data to examine cognition in relation to BP measures. RESULTS In age, sex, and education adjusted models, systolic, pulse, and mean arterial pressure were consistently negatively associated with executive function, psychomotor speed and sustained attention, verbal episodic learning and memory, speech fluency, and mental status measures. These associations were attenuated but remained statistically significant in fully adjusted models. CONCLUSION Among middle-aged and older diverse Hispanics/Latinos, we found modest but consistent associations between indicators of arterial stiffness, and compromised blood flow and lower cognitive function. Clinical management and public health interventions to raise awareness and enhance BP management beginning in midlife could reduce disparities and improve population health by reducing cognitive decline burdens.
Collapse
Affiliation(s)
- Wassim Tarraf
- Department of Healthcare Sciences and Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Carlos J Rodríguez
- Department of Medicine and Department of Epidemiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Martha L Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine at Chicago, Chicago, IL, USA.,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Linda Gallo
- San Diego State University, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego, CA, USA
| | - Gregory A Talavera
- San Diego State University, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego, CA, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Myriam Fornage
- University of Texas Health Science Center, Institute of Molecular Medicine and Human Genetics Center, San Antonio, TX, USA
| | - Alan Conceicao
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Hector M González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
32
|
Tarraf W, Criqui MH, Allison MA, Wright CB, Fornage M, Daviglus M, Kaplan RC, Davis S, Conceicao AS, González HM. Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos. Atherosclerosis 2018; 271:61-69. [PMID: 29459267 DOI: 10.1016/j.atherosclerosis.2018.02.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/17/2018] [Accepted: 02/08/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS The Ankle-Brachial index (ABI) is a well-accepted measure of peripheral artery disease (arterial stenosis and stiffness) and has been shown to be associated with cognitive function and disorders; however, these associations have not been examined in Hispanics/Latinos. Therefore, we sought to examine relationships between ABI and cognitive function among diverse middle-age and older Hispanics/Latinos. METHODS We used cross-sectional data on n = 7991 participants aged 45-74 years, without stroke or coronary heart disease, from the Hispanic Community Health Study/Study of Latinos. Our primary outcome, global cognition (GC), was a continuous composite score of four cognitive domains (verbal learning and memory, verbal fluency, executive function, and mental status). Secondary outcomes were the individual tests representing these domains. The ABI was analyzed continuously and categorically with standard clinical cut-points. We tested associations using generalized survey regression models incrementally adjusting for confounding factors. Age, sex, hypertension, diabetes, and dyslipidemia moderations were examined through interactions with the primary exposure. RESULTS In age, sex, and education adjusted models, continuous ABI had an inverse u-shape association with worse GC. We found similar associations with measures of verbal learning and memory, verbal fluency, executive function, but not with low mental status. The associations were attenuated, but not completely explained, by accounting for the confounders and not modified by age, sex, education, and vascular disease risks. CONCLUSIONS In addition to being a robust indicator of arterial compromise, our study suggests that abnormal ABI readings may also be useful for early signaling of subtle cognitive deficits.
Collapse
Affiliation(s)
- Wassim Tarraf
- Institute of Gerontology & Department of Health Care Sciences, Wayne State University, 87 East Ferry St., 240 Knapp Building, Detroit, MI, 48202, USA
| | - Michael H Criqui
- Family and Preventative Medicine, University of California San Diego, 9500 Gilman Drive, MC 0607, SCRB 352, La Jolla, CA, 92093-0607, USA
| | - Matthew A Allison
- Family and Preventative Medicine, University of California San Diego, 9500 Gilman Drive, MC 0965, La Jolla, CA, 92093-0607, USA
| | - Clinton B Wright
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 6001 Executive Boulevard Suite 3309, Bethesda, MD, 20892-9531, USA
| | - Myriam Fornage
- University of Texas Health Science Center at Houston, 1825 Pressler Street, Building SRB-530G, Houston, TX, 77030, USA
| | - Martha Daviglus
- Department of Preventative Medicine, University of Illinois-Chicago, Feinberg School of Medicine, 1819 W. Polk Street, MC 764, Suite 246, Chicago, IL, 60612, USA
| | - Robert C Kaplan
- Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Belfer Building Room 1306C, Bronx, NY, 10461, USA
| | - Sonia Davis
- Department of Biostatistics, University of North Carolina at Chapel Hill, 137 East Franklin St, Suite 203, Chapel Hill, NC, 27514, USA
| | - Alan S Conceicao
- Department of Epidemiology & Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Hector M González
- UC San Diego, Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, La Jolla, CA, 92093-0949, USA.
| |
Collapse
|
33
|
Wiese LK, Williams CL, Tappen R, Newman D, Rosselli M. Assessment of Basic Knowledge About Alzheimer’s Disease Among Older Rural Residents: A Pilot Test of a New Measure. J Nurs Meas 2017; 25:519-548. [DOI: 10.1891/1061-3749.25.3.519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Underserved rural populations face a higher risk of Alzheimer’s disease (AD), yet studies investigating AD knowledge in this population are lacking. The purpose of this research was to develop an AD basic knowledge measure that is appropriate for use with underserved populations. Method: A content domain map, content validity index, and cognitive interviews were used in developing the first version of the basic knowledge of Alzheimer’s disease (BKAD; Study 1). Reliability and validity of the measure in this descriptive study were examined using Rasch modeling and tests for construct, concurrent, and discriminate validity (Study 2). Multiple regression was employed to examine AD knowledge predictors. Results: Findings included that the BKAD instrument discriminated well between persons with varied education levels. Psychometric analysis yielded important information to guide revision of the BKAD measure. Conclusion: The BKAD measure shows promise in meeting the need for a culturally relevant measure to assess basic Alzheimer’s disease knowledge in underserved rural populations.
Collapse
|