RELATIONSHIPS OF VERY SMALL, INFARCT-LIKE LESIONS WITH 20-YEAR COGNITIVE DECLINE: THE ARIC STUDY

Background: Midlife obesity is associated with dementia in later life, but how the metabolic syndrome (MetS) relates to cognitive change is less understood. We hypothesized that MetS would be more predictive of 6-year cognitive decline than its individual components in a large biethnic cohort (the ARIC study) and that combinations of risk factors would further increase likelihood of change. Methods: The MetS was defined in 1987-89 on 10,687 participants with two cognitive assessments at two time points. In subjects aged 44 to 66, obesity measures included body mass index (BMI) and waist-to-hip ratio (WTHR). The main outcome measure was change in 1990-92 to 96-99 of three cognitive tests: Delayed Word Recall (DWR), Digit Symbol Substitution Test (DSST), and Word Fluency Test (WFT). Linear and logistic regressions were all adjusted for age, combined race-center, sex, education, smoking, drinking, coronary artery disease and prior stroke. Change was measured as the difference divided by the number of years between visits. Results: At baseline, the prevalence of MetS was 22% (mean age 54 years, 27% black, 55% female, and 28% BMI>30 kg/m2). Subjects with MetS performed in the lowest test quintile (adjusted ORs: DWR 1.3 95% CI 1.1-1.4) in 1996-99, and much of this effect size was explained by an elevated WTHR (DWR OR 1.3 CI 1.1-1.5) and diabetes (DWR OR 1.4 CI 1.2-1.7). MetS was not associated with annual cognitive change, and diabetes was the only significant component associated with change (adjusted beta: DWR 0.03 p=.01, DSST 0.2 p<.001, WFT 0.09 p=.01). Conclusion: MetS at ages 44 to 66 was associated with worse cognitive function at follow-up, but not with annual cognitive decline over several years. Elevated WTHR and diabetes explained most of the association of MetS with cognitive function measures, and diabetes with cognitive decline. Until we have a definition of the MetS more based on pathophysiology, the components of the MetS should be the focus of analysis in future studies.

Download Full-text

Association of lung function with cognitive decline and dementia: the Atherosclerosis Risk in Communities (ARIC) Study

European Journal of Neurology ◽

10.1111/j.1468-1331.2010.03340.x ◽

2011 ◽

Vol 18 (6) ◽

pp. 888-898 ◽

Cited By ~ 44

Author(s):

S. S. Pathan ◽

R. F. Gottesman ◽

T. H. Mosley ◽

D. S. Knopman ◽

A. R. Sharrett ◽

...

Keyword(s):

Lung Function ◽

Cognitive Decline ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

Download Full-text

Cognitive Decline and Oral Health in Middle-aged Adults in the ARIC Study

Journal of Dental Research ◽

10.1177/0022034513497960 ◽

2013 ◽

Vol 92 (9) ◽

pp. 795-801 ◽

Cited By ~ 44

Author(s):

S. Naorungroj ◽

G.D. Slade ◽

J.D. Beck ◽

T.H. Mosley ◽

R.F. Gottesman ◽

...

Keyword(s):

Oral Health ◽

Cognitive Decline ◽

Middle Aged ◽

Middle Aged Adults ◽

Aric Study

Download Full-text

Obstructive Sleep Apnea and 15-Year Cognitive Decline: The Atherosclerosis Risk in Communities (ARIC) Study

SLEEP ◽

10.5665/sleep.5434 ◽

2016 ◽

Vol 39 (2) ◽

pp. 309-316 ◽

Cited By ~ 24

Author(s):

Pamela L. Lutsey ◽

Lindsay G.S. Bengtson ◽

Naresh M. Punjabi ◽

Eyal Shahar ◽

Thomas H. Mosley ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cognitive Decline ◽

Atherosclerosis Risk In Communities ◽

Obstructive Sleep ◽

Atherosclerosis Risk ◽

Aric Study

Download Full-text

Abstract 28: Orthostatic Hypotension is Associated With 20-year Cognitive Decline and Incident Dementia: the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.135.suppl_1.28 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Andreea Rawlings ◽

Stephen Juraschek ◽

Gerardo Heiss ◽

Timothy Hughes ◽

Michelle Meyer ◽

...

Keyword(s):

Cognitive Decline ◽

Orthostatic Hypotension ◽

Cox Regression ◽

Underlying Disease ◽

P Value ◽

Atherosclerosis Risk In Communities ◽

Incident Dementia ◽

History Of ◽

Aric Study

Background: Orthostatic hypotension (OH) has been associated with incident cardiovascular disease and all-cause mortality, but few studies have examined long-term associations with cognitive decline and dementia Hypothesis: OH will be associated with greater cognitive decline and risk of incident dementia Methods: We prospectively analyzed 11503 participants who attended visit 1 (1987-1989) of the ARIC study and had no history of coronary heart disease or stroke. OH was defined as a drop in systolic blood pressure (BP) >=20 mmHg or a drop in diastolic BP >=10 mmHg upon standing from a supine position. Dementia was ascertained using cohort surveillance, telephone contact with the participant or their proxy, or a comprehensive cognitive and neurologic exam in 2011-2013. Cognition was measured via three neuropsychological tests administered in 1990-1992, 1996-1998, and 2011-2013 that were summarized using a Z score. We used adjusted Cox regression and linear mixed models. Results: At visit 1 (mean age 54 years, 57% female, 27% black) 6% of participants had OH. In adjusted models, persons with OH at baseline were 40% more likely to develop dementia than those without OH (HR: 1.40, 95%CI: 1.13, 1.73; Table). Associations were significantly larger in persons with hypertension (p-value for interaction=0.023). Persons with OH compared to those without had significantly more cognitive decline over 20 years (difference: -0.12, 95% CI: -0.23, -0.02; Table). Conclusions: OH assessed in midlife was independently associated with incident dementia and cognitive decline over 20 years. Although typically considered a transient mechanism, these data suggest that OH, or the underlying disease conditions manifesting as OH, persist over time. Whether OH is a marker of vulnerability beyond that of standard hypertension measures, or whether repeated transient exposure to hypotension reduces perfusion to the brain sufficiently to lead to long-term cerebral dysfunction is an important area for further research.

Download Full-text

Milk Intake at Midlife and Cognitive Decline over 20 Years. The Atherosclerosis Risk in Communities (ARIC) Study

Nutrients ◽

10.3390/nu9101134 ◽

2017 ◽

Vol 9 (10) ◽

pp. 1134 ◽

Cited By ~ 8

Author(s):

Natalia Petruski-Ivleva ◽

Anna Kucharska-Newton ◽

Priya Palta ◽

David Couper ◽

Katie Meyer ◽

...

Keyword(s):

Cognitive Decline ◽

Milk Intake ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

Download Full-text

EFFECTS OF CEREBROVASCULAR INFARCT BURDEN ON COGNITIVE DECLINE IN THE PRESENCE OF DEMENTIA AND DEATH: ACCOUNTING FOR POTENTIALLY INFORMATIVE DROPOUT USING COMPETING RISK SHARED PARAMETER MODELS: THE ARIC STUDY

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.07.213 ◽

2017 ◽

Vol 13 (7) ◽

pp. P586

Author(s):

Michael E. Griswold ◽

Dan Su ◽

Jonathan V. Tingle ◽

Steven R. Wilkening ◽

Andreea Rawlings ◽

...

Keyword(s):

Cognitive Decline ◽

Competing Risk ◽

Informative Dropout ◽

Aric Study

Download Full-text

GLUCOSE PEAKS AND COGNITIVE DECLINE: ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY

Innovation in Aging ◽

10.1093/geroni/igx004.335 ◽

2017 ◽

Vol 1 (suppl_1) ◽

pp. 81-81

Author(s):

A. Rawlings ◽

A. Sharrett ◽

T.H. Mosley ◽

S. Ballew ◽

J.A. Deal ◽

...

Keyword(s):

Cognitive Decline ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study

Download Full-text

Low Serum Magnesium is Associated with Incident Dementia in the ARIC-NCS Cohort

Nutrients ◽

10.3390/nu12103074 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3074

Author(s):

Aniqa B. Alam ◽

Pamela L. Lutsey ◽

Rebecca F. Gottesman ◽

Adrienne Tin ◽

Alvaro Alonso

Keyword(s):

Cognitive Function ◽

Cognitive Decline ◽

Serum Magnesium ◽

Cognitive Domain ◽

Atherosclerosis Risk In Communities ◽

Incident Dementia ◽

Increased Risk ◽

Aric Study ◽

Multiple Morbidities

Higher serum magnesium is associated with lower risk of multiple morbidities, including diabetes, stroke, and atrial fibrillation, but its potential neuroprotective properties have also been gaining traction in cognitive function and decline research. We studied 12,040 participants presumed free of dementia in the Atherosclerosis Risk in Communities (ARIC) study. Serum magnesium was measured in fasting blood samples collected in 1990–1992. Dementia status was ascertained through cognitive examinations in 2011–2013, 2016–2017, and 2018–2019, along with informant interviews and indicators of dementia-related hospitalization events and death. Participants’ cognitive functioning capabilities were assessed up to five times between 1990–1992 and 2018–2019. The cognitive function of participants who did not attend follow-up study visits was imputed to account for attrition. We identified 2519 cases of dementia over a median follow-up period of 24.2 years. The lowest quintile of serum magnesium was associated with a 24% higher rate of incident dementia compared to those in the highest quintile of magnesium (HR, 1.24; 95% CI, 1.07, 1.44). No relationship was found between serum magnesium and cognitive decline in any cognitive domain. Low midlife serum magnesium is associated with increased risk of incident dementia, but does not appear to impact rates of cognitive decline.

Download Full-text