Neighborhood Greenspace and Cognition: The Cardiovascular Health Study

Abstract Access to greenspace has been positively associated with cognition among older adults, however prior research has been limited in temporal and geographic scope. We evaluated associations between neighborhood greenspace and incidence of dementia and change in cognitive functioning using a longitudinal sample of non-demented adults (n=2,465) from the Cardiovascular Health and Cognition Study. Percent greenness (1-km radial buffers) was derived from the National Land Cover Dataset. Cognitive function was measured using the Mini-Mental State Examination (3MSE) and dementia status was clinically adjudicated. Cox proportional hazard and logistics regression analyses were used to examine associations of baseline greenness with risk of incident dementia and risk of mild cognitive impairment, respectively. Generalized linear mixed models accounting for within-subject correlations were used to examine the association between greenspace in the neighborhood at baseline and 3MSE score (1991-1999). Ongoing results will be presented, along with modifiers and mediators of associations.

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Associations of body composition with incident dementia in older adults: Cardiovascular Health Study‐Cognition Study

Alzheimer s & Dementia ◽

10.1002/alz.12125 ◽

2020 ◽

Vol 16 (10) ◽

pp. 1402-1411

Author(s):

Chendi Cui ◽

Rachel H. Mackey ◽

C. Elizabeth Shaaban ◽

Lewis H. Kuller ◽

Oscar L. Lopez ◽

...

Keyword(s):

Older Adults ◽

Body Composition ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study ◽

Incident Dementia

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Association between cognitive impairment and criteria for frailty syndrome among older adults

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190138 ◽

2020 ◽

Vol 78 (1) ◽

pp. 2-8 ◽

Cited By ~ 1

Author(s):

Allan Gustavo BRIGOLA ◽

Ana Carolina OTTAVIANI ◽

Danilo Henrique Trevisan CARVALHO ◽

Nathalia Alves OLIVEIRA ◽

Érica Nestor SOUZA ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cardiovascular Health ◽

Functional Dependence ◽

Health Study ◽

Cardiovascular Health Study ◽

Multinomial Regression ◽

Cognitive Frailty ◽

Elderly Caregivers ◽

State Examination

Abstract The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. Objective: To analyze the association between cognitive impairment and the criteria for frailty. Methods: We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled ‘Variables associated to cognition in elderly caregivers’ involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. Results: Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. Conclusion: Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty.

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Association of CD14 with incident dementia and markers of brain aging and injury

Neurology ◽

10.1212/wnl.0000000000008682 ◽

2019 ◽

Vol 94 (3) ◽

pp. e254-e266 ◽

Cited By ~ 1

Author(s):

Matthew P. Pase ◽

Jayandra J. Himali ◽

Alexa S. Beiser ◽

Charles DeCarli ◽

Emer R. McGrath ◽

...

Keyword(s):

Brain Atrophy ◽

Cardiovascular Health ◽

Brain Aging ◽

Inflammatory Marker ◽

Meta Analysis ◽

Health Study ◽

Cardiovascular Health Study ◽

Community Based ◽

Brain Volumes ◽

Incident Dementia

ObjectiveTo test the hypothesis that the inflammatory marker plasma soluble CD14 (sCD14) associates with incident dementia and related endophenotypes in 2 community-based cohorts.MethodsOur samples included the prospective community-based Framingham Heart Study (FHS) and Cardiovascular Health Study (CHS) cohorts. Plasma sCD14 was measured at baseline and related to the incidence of dementia, domains of cognitive function, and MRI-defined brain volumes. Follow-up for dementia occurred over a mean of 10 years (SD 4) in the FHS and a mean of 6 years (SD 3) in the CHS.ResultsWe studied 1,588 participants from the FHS (mean age 69 ± 6 years, 47% male, 131 incident events) and 3,129 participants from the CHS (mean age 72 ± 5 years, 41% male, 724 incident events) for the risk of incident dementia. Meta-analysis across the 2 cohorts showed that each SD unit increase in sCD14 was associated with a 12% increase in the risk of incident dementia (95% confidence interval 1.03–1.23; p = 0.01) following adjustments for age, sex, APOE ε4 status, and vascular risk factors. Higher levels of sCD14 were associated with various cognitive and MRI markers of accelerated brain aging in both cohorts and with a greater progression of brain atrophy and a decline in executive function in the FHS.ConclusionsCD14 is an inflammatory marker related to brain atrophy, cognitive decline, and incident dementia.

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O3-11-04: ARTERIAL STIFFNESS IS ASSOCIATED WITH INCREASED RISK OF INCIDENT DEMENTIA IN THE OLDER ELDERLY: THE CARDIOVASCULAR HEALTH STUDY

Alzheimer s & Dementia ◽

10.1016/j.jalz.2018.06.2834 ◽

2006 ◽

Vol 14 (7S_Part_19) ◽

pp. P1048-P1048

Author(s):

Chendi Cui ◽

Akira Sekikawa ◽

Lewis H. Kuller ◽

Oscar L. Lopez ◽

Anne B. Newman ◽

...

Keyword(s):

Arterial Stiffness ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study ◽

Incident Dementia ◽

Increased Risk

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Abstract P007: Arterial Stiffness is Associated With Increased Risk of Incident Dementia in the Older Elderly: The Cardiovascular Health Study Cognition Study

Circulation ◽

10.1161/circ.137.suppl_1.p007 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Chendi Cui ◽

Akira Sekikawa ◽

Lewis Kuller ◽

Oscar Lopez ◽

Anne Newman ◽

...

Keyword(s):

Older Adults ◽

Arterial Stiffness ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study ◽

Risk Of Death ◽

Incident Dementia ◽

Increased Risk ◽

Age And Sex

Introduction: Arterial stiffness is related to aging, hypertension, and obesity, and higher carotid-femoral pulse wave velocity (PWV) is associated with brain amyloid deposition. We hypothesized that higher cfPWV was associated with incident dementia in older adults (mean age 78) of the Cardiovascular Health Study Cognition Study (CHS-CS). Methods: Pittsburgh CHS-CS participants (n=532) without dementia at baseline (1998-99) had annual cognitive exams through 2013. CfPWV (m/sec) was measured from pulse velocity waveforms on 356 participants between 1996-2000, who were slightly younger, more educated, with less mild cognitive impairment (MCI) than those not included. Associations of cfPWV [continuous (transformed: -1/cfPWV) and quartile] with time-to-event [cfPWV measurement to dementia or death (competing event), or end of follow-up] were assessed in Cox proportional hazards model with competing risk of death. Results: Over 15-year follow-up, 212 (59.6%) dementia cases (median onset time=4 years) and 87 (24.4%) deaths occurred prior to dementia diagnosis. Adjusted for age and sex, incident dementia was related to higher cfPWV [hazard ratio (HR)=1.52 per -1/cfPWV, 95%CI=1.04, 2.24] (Table). Results were similar when further adjusted for education, race, ApoE4 , hypertension, diabetes, MCI, and abnormal white matter (WMG) or ventricular grade (VG). Results persisted in separate models that excluded those with ApoE4 + (n=79), diabetes (n=40), MCI (n=65) or abnormal WMG or VG (n=136). In stratified models, results were stronger for age ≥80 vs. <80 and for hypertension vs. no hypertension. Pulse pressure (PP), another index of arterial stiffness, was not associated with incident dementia (age- and sex-adjusted HR=1.01 per mmHg PP, 95%CI=0.99, 1.01). Conclusions: Higher cfPWV, but not higher PP, was significantly associated with incident dementia in the older adults. Interventions to slow arterial stiffness with aging may reduce the risk of dementia among older individuals.

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Level and Change in N-Terminal Pro-B-Type Natriuretic Peptide and Kidney Function and Survival to Age 90

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa124 ◽

2020 ◽

Author(s):

Astrid D Häberle ◽

Mary L Biggs ◽

Mary Cushman ◽

Bruce M Psaty ◽

Anne B Newman ◽

...

Keyword(s):

Risk Factors ◽

Natriuretic Peptide ◽

Mixed Models ◽

Cardiovascular Health ◽

Fold Increase ◽

Health Study ◽

Cardiovascular Health Study ◽

Very Old Age ◽

Older Populations ◽

Age Studies

Abstract Background Many traditional cardiovascular risk factors do not predict survival to very old age. Studies have shown associations of estimated glomerular filtration rate (eGFR) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) with cardiovascular disease and mortality in older populations. This study aimed to evaluate the associations of the level and change in eGFR and NT-pro-BNP with longevity to age 90 years. Method The population included participants (n = 3,645) in the Cardiovascular Health Study, aged between 67 and 75 at baseline. The main exposures were eGFR, calculated with the Berlin Initiative Study (BIS) 2 equation, and NT-pro-BNP, and the main outcome was survival to age 90. Mixed models were used to estimate level and change of the main exposures. Results There was an association between baseline level and change of both eGFR and NT-pro-BNP and survival to 90, and this association persisted after adjustment for covariates. Each 10 mL/min/1.73 m2 higher eGFR level was associated with an adjusted odds ratio (OR) of 1.23 (95% CI: 1.13, 1.34) of survival to 90, and a 0.5 mL/min/1.73 m2 slower decline in eGFR was associated with an OR of 1.51 (95% CI: 1.31, 1.74). A twofold higher level of NT-pro-BNP level had an adjusted OR of 0.67 (95% CI: 0.61, 0.73), and a 1.05-fold increase per year in NT-pro-BNP had an OR of 0.53 (95% CI: 0.43, 0.65) for survival to age 90. Conclusion eGFR and NT-pro-BNP appear to be important risk factors for longevity to age 90.

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