Vascular Risk Factors and Brain Health in Aging: Insights from a Community-Based Cohort Study

Article type: Research Article

Authors: Wang, Wenxiao^{a; b; 1} | Yang, Yiru^{c; 1} | Sang, Feng^{a; d} | Chen, Yaojing^{a; d} | Li, Xin^{a; d} | Chen, Kewei^{d; e} | Wang, Jun^{a; d} | Zhang, Zhanjun^{a; d; *}

Affiliations: [a] Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China | [b] School of Systems Science, Beijing Normal University, Beijing, China | [c] School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China | [d] Beijing Aging Brain Rejuvenation Initiative (BABRI Centre), Beijing Normal University, Beijing, China | [e] Banner Alzheimer’s Institute, Phoenix, AZ, USA

Correspondence: [*] Correspondence to: Zhanjun Zhang, MD, Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, No. 19 Xinjiekouwai St, Haidian District, Beijing 100875, China. Tel.: +86 10 58802005; Fax: +86 10 58802005; E-mail: zhang_rzs@bnu.edu.cn.

Note: [1] These authors contributed equally to this work.

Abstract: Background:The aging population and high rates of Alzheimer’s disease (AD) create significant medical burdens, prompting a need for early prevention. Targeting modifiable risk factors like vascular risk factors (VRFs), closely linked to AD, may provide a promising strategy for intervention. Objective:This study investigates how VRFs influence cognitive performance and brain structures in a community-based cohort. Methods:In this cross-sectional study, 4,667 participants over 50 years old, drawn from the Beijing Ageing Brain Rejuvenation Initiative project, were meticulously examined. Cognitive function and VRFs (diabetes mellitus, hypertension, hyperlipidemia, obesity, and smoking), were comprehensively assessed through one-to-one interviews. Additionally, a subset of participants (n = 719) underwent MRI, encompassing T1-weighted and diffusion-weighted scans, to elucidate gray matter volume and white matter structural network organization. Results:The findings unveil diabetes as a potent detriment to memory, manifesting in atrophy within the right supramarginal gyrus and diminished nodal efficiency and degree centrality in the right inferior parietal lobe. Hypertension solely impaired memory without significant structural changes. Intriguingly, individuals with comorbid diabetes and hypertension exhibited the most pronounced deficits in both brain structure and cognitive performance. Remarkably, hyperlipidemia emerged as a factor associated with enhanced cognition, and preservation of brain structure. Conclusions:This study illuminates the intricate associations between VRFs and the varied patterns of cognitive and brain structural damage. Notably, the synergistic effect of diabetes and hypertension emerges as particularly deleterious. These findings underscore the imperative to tailor interventions for patients with distinct VRF comorbidities, especially when addressing cognitive decline and structural brain changes.

Keywords: Aging cohort, Alzheimer’s disease, brain structural, cognitive performance, vascular risk factors

DOI: 10.3233/JAD-240240

Journal: Journal of Alzheimer's Disease, vol. 99, no. 4, pp. 1361-1374, 2024