Subclinical atherosclerotic calcification and cognitive functioning inmiddle-aged adults: The CARDIA study

Jared P. Reis, Lenore J. Launer, James G. Terry, Catherine M. Loria, Adina Zeki Al Hazzouri, Stephen Sidney, Kristine Yaffe, David R. Jacobs, Christopher T. Whitlow, Na Zhu, J. Jeffrey Carr

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective: Cardiovascular risk factors in middle-age are associated with cognitive impairment and dementia in older age. Less is known about the burden of calcified subclinical atherosclerosis and cognition, especially in midlife. We examined the association of coronary artery and abdominal aortic calcified plaque (CAC and AAC, respectively) with cognitive functioning in middle-aged adults. Methods: This cross-sectional study included 2510 black and white adults (age: 43-55 years) without heart disease or stroke who completed a year 25 follow-up exam (2010-11) as part of the Coronary Artery Risk Development in Young Adults Study. CAC and AAC were measured with non-contrast computed tomography. Cognition was assessed with the Digit Symbol Substitution Test (DSST) (psychomotor speed), Stroop Test (executive function), and Rey Auditory Verbal Learning Test (RAVLT) (verbal memory). Results: A greater amount of CAC and AAC was associated with worse performance on each test of cognitive function after adjustment for age, sex, race, education, and study center. Associations were attenuated, but remained significant for the DSST and RAVLT following additional adjustment for vascular risk factors, including adiposity, smoking, alcohol use, dyslipidemia, hypertension, and diabetes. Compared to participants without CAC or AAC, those with both CAC and AAC, but not CAC or AAC alone was associated with lower DSST scores (p<0.05). Conclusions: In this community-based sample, greater subclinical atherosclerotic calcification was associated with worse psychomotor speed and memory in midlife. These findings underscore the importance of a life course approach to the study of cognitive impairment with aging.

Original languageEnglish (US)
Pages (from-to)72-77
Number of pages6
JournalAtherosclerosis
Volume231
Issue number1
DOIs
StatePublished - Nov 2013
Externally publishedYes

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Cognition
Verbal Learning
Coronary Vessels
Stroop Test
Sex Education
Executive Function
Adiposity
Dyslipidemias
Dementia
Young Adult
Heart Diseases
Atherosclerosis
Cross-Sectional Studies
Smoking
Stroke
Tomography
Alcohols
Hypertension
Cognitive Dysfunction
hydroquinone

Keywords

  • Atherosclerosis
  • Cognition
  • Risk factors
  • Subclinical disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Subclinical atherosclerotic calcification and cognitive functioning inmiddle-aged adults : The CARDIA study. / Reis, Jared P.; Launer, Lenore J.; Terry, James G.; Loria, Catherine M.; Zeki Al Hazzouri, Adina; Sidney, Stephen; Yaffe, Kristine; Jacobs, David R.; Whitlow, Christopher T.; Zhu, Na; Carr, J. Jeffrey.

In: Atherosclerosis, Vol. 231, No. 1, 11.2013, p. 72-77.

Research output: Contribution to journalArticle

Reis, JP, Launer, LJ, Terry, JG, Loria, CM, Zeki Al Hazzouri, A, Sidney, S, Yaffe, K, Jacobs, DR, Whitlow, CT, Zhu, N & Carr, JJ 2013, 'Subclinical atherosclerotic calcification and cognitive functioning inmiddle-aged adults: The CARDIA study', Atherosclerosis, vol. 231, no. 1, pp. 72-77. https://doi.org/10.1016/j.atherosclerosis.2013.08.038
Reis, Jared P. ; Launer, Lenore J. ; Terry, James G. ; Loria, Catherine M. ; Zeki Al Hazzouri, Adina ; Sidney, Stephen ; Yaffe, Kristine ; Jacobs, David R. ; Whitlow, Christopher T. ; Zhu, Na ; Carr, J. Jeffrey. / Subclinical atherosclerotic calcification and cognitive functioning inmiddle-aged adults : The CARDIA study. In: Atherosclerosis. 2013 ; Vol. 231, No. 1. pp. 72-77.
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AU - Reis, Jared P.

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AU - Terry, James G.

AU - Loria, Catherine M.

AU - Zeki Al Hazzouri, Adina

AU - Sidney, Stephen

AU - Yaffe, Kristine

AU - Jacobs, David R.

AU - Whitlow, Christopher T.

AU - Zhu, Na

AU - Carr, J. Jeffrey

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N2 - Objective: Cardiovascular risk factors in middle-age are associated with cognitive impairment and dementia in older age. Less is known about the burden of calcified subclinical atherosclerosis and cognition, especially in midlife. We examined the association of coronary artery and abdominal aortic calcified plaque (CAC and AAC, respectively) with cognitive functioning in middle-aged adults. Methods: This cross-sectional study included 2510 black and white adults (age: 43-55 years) without heart disease or stroke who completed a year 25 follow-up exam (2010-11) as part of the Coronary Artery Risk Development in Young Adults Study. CAC and AAC were measured with non-contrast computed tomography. Cognition was assessed with the Digit Symbol Substitution Test (DSST) (psychomotor speed), Stroop Test (executive function), and Rey Auditory Verbal Learning Test (RAVLT) (verbal memory). Results: A greater amount of CAC and AAC was associated with worse performance on each test of cognitive function after adjustment for age, sex, race, education, and study center. Associations were attenuated, but remained significant for the DSST and RAVLT following additional adjustment for vascular risk factors, including adiposity, smoking, alcohol use, dyslipidemia, hypertension, and diabetes. Compared to participants without CAC or AAC, those with both CAC and AAC, but not CAC or AAC alone was associated with lower DSST scores (p<0.05). Conclusions: In this community-based sample, greater subclinical atherosclerotic calcification was associated with worse psychomotor speed and memory in midlife. These findings underscore the importance of a life course approach to the study of cognitive impairment with aging.

AB - Objective: Cardiovascular risk factors in middle-age are associated with cognitive impairment and dementia in older age. Less is known about the burden of calcified subclinical atherosclerosis and cognition, especially in midlife. We examined the association of coronary artery and abdominal aortic calcified plaque (CAC and AAC, respectively) with cognitive functioning in middle-aged adults. Methods: This cross-sectional study included 2510 black and white adults (age: 43-55 years) without heart disease or stroke who completed a year 25 follow-up exam (2010-11) as part of the Coronary Artery Risk Development in Young Adults Study. CAC and AAC were measured with non-contrast computed tomography. Cognition was assessed with the Digit Symbol Substitution Test (DSST) (psychomotor speed), Stroop Test (executive function), and Rey Auditory Verbal Learning Test (RAVLT) (verbal memory). Results: A greater amount of CAC and AAC was associated with worse performance on each test of cognitive function after adjustment for age, sex, race, education, and study center. Associations were attenuated, but remained significant for the DSST and RAVLT following additional adjustment for vascular risk factors, including adiposity, smoking, alcohol use, dyslipidemia, hypertension, and diabetes. Compared to participants without CAC or AAC, those with both CAC and AAC, but not CAC or AAC alone was associated with lower DSST scores (p<0.05). Conclusions: In this community-based sample, greater subclinical atherosclerotic calcification was associated with worse psychomotor speed and memory in midlife. These findings underscore the importance of a life course approach to the study of cognitive impairment with aging.

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