- Email: [email protected]
Long-term patterns of low physical activity and cognitive function in mid-life: the CARDIA Study
P134
Oral Sessions: O1-05: Public Health and Psychosocial Focus: Epidemiology I—Cardiovascular Risks
210 CN individuals (Clinical Dementia Rating Scale ¼ 0) who underwent clinical assessment and PiB-PET imaging. Cortical PiB retention was evaluated using a distribution volume ratio (DVR), using cerebellar cortex as tissue reference. SCC was measured by three questionnaires: the Everyday Cognition Scale, the Memory Functioning Questionnaire, and several questions from the Structured Telephone Interview for Dementia Assessment. A composite of SCC-M and SCC-E items were calculated respectively. A composite of verbal intelligence (AMNART IQ) and the Hollingshead scale was used as a proxy for cognitive reserve (CR). Subjects were classified as either low or high CR based on a median split of their composite score. Multivariate models related PiB retention to SCC-M and SCC-E for the low and high reserve groups. Results: Higher PiB retention was associated with greater SCC-M in both high and low reserve groups (High: b ¼0.98, p¼0.006; Low: b ¼1.12, p¼0.013). By contrast, there was a relationship between PiB and SCC-E for the high reserve group (b ¼0.95, p¼0.010), but not the low reserve group (b ¼0.23, p¼0.554). Conclusions: We found a relationship between SCC-M and amyloid burden at all levels of cognitive reserve. However, the relationship between SCC-E and amyloid burden appears more complex, with level of cognitive reserve modulating this relationship. Taken together, SCC-E, in addition to SCC-M, appears to be a potential indicator of early AD pathology, but may depend on level of cognitive reserve.
O1-04-05
HIGH-PERFORMING OLDER ADULTS: COGNITIVE AND BRAIN CORRELATES
Miranka Wirth1, Grace Tang1, Sylvia Villeneuve1, Cindee Madison2, Hwamee Oh1, William Jagust1, 1University of California, Berkeley, Berkeley, California, United States; 2Helen Wills Neuroscience Institute, Berkeley, California, United States. Contact e-mail: miranka.wirth@ gmail.com Background: Older adults with high cognitive abilities are suggested to have relatively preserved brain structures. The aim of this study was to identity different patterns of cognition and their underlying brain correlates in cognitively normal older adults. In addition the parameters were compared to a group of young adults. Methods: Cognitive test data of 286 cognitively normal older individuals from the Berkeley Aging Cohort were included; 71 of these people underwent multi-modal neuroimaging (MRI and PIB-PET). 112 younger individuals were examined using the same cognitive tests; 48 of these subjects had MR imaging. First, a cluster analysis identified groups of older adults that showed similar patterns in age-adjusted executive and memory function composite measures. Higher older performers were compared to the other groups with regard to self-evaluated cognitive abilities and brain pathology of beta-amyloid burden, measured using PIB-PET and white matter lesions volumes. Second, structural correlates explaining variability in executive functions and memory were assessed in the older and younger individuals. Third, high older performers were compared in cognitive abilities and structural correlates to young individuals. Results: The cluster analysis indicated four groups in the older individuals: high performers with above-average executive functions and memory, overall low performers, and two mixed groups with either decreased executive or memory functions. High older performers (EF+M+) did not differ from the other groups in education, age, and beta-amyloid burden or white matter lesion volumes. However, they evaluated their own cognitive abilities as superior. Within the older group, higher executive functions correlated with thicker cortex throughout heteromodal regions; higher memory performance was associated with increased hippocampal volume. The correlative patterns were not seen in younger individuals. Although high older performers exhibited above-average cortical thickness, their cognitive abilities, cortical thickness and hippocampal volume were nevertheless reduced in comparison to younger adults. Conclusions: Higher executive and memory functions in older age are mainly associated with thicker cortex in distributed regions and larger hippocampal volume, but not reduced brain pathology. The absence of the correlative relationships in the young and the age-related differences in cognitive functions
and structural correlates suggest differential aging in the elders as opposed to developmental differences.
O1-04-06
RELATIONSHIP OF COGNITIVE RESERVE AND APOE STATUS TO CLINICAL SYMPTOM ONSET OF MILD COGNITIVE IMPAIRMENT: THE BIOCARD COHORT
Anja Soldan1, Corinne Pettigrew1, Mei-Cheng Wang2, Shanshan Li2, Yi Lu2, Marilyn Albert3, Ola Selnes1, 1Johns Hopkins School of Medicine, Baltimore, Maryland, United States; 2Johns Hopkins School of Public Health, Baltimore, Maryland, United States; 3Johns Hopkins University, Baltimore, Maryland, United States. Contact e-mail: [email protected] Background: The primary genetic risk factor for late-onset AD is the apolipoprotein E epsilon-4 (APOE-4) allele, which is thought to increase the risk of AD by decreasing the clearance of amyloid from the brain. The APOE epsilon-2 (APOE-2) allele, by comparison, decreases the risk of developing AD dementia. Possession of one or two APOE-4 alleles, however, is neither necessary nor sufficient for developing AD dementia and possession of one or two APOE-2 alleles does not prevent dementia. Methods: This study examined the extent to which cognitive reserve (CR) modifies the association between APOE status and the risk of developing clinical symptoms preceding MCI. CR is a theoretical construct proposing that differences in lifetime experiences, such as more education and cognitive activity, may permit individuals to sustain greater levels of brain pathology before showing clinical symptoms. Measures of cognitive reserve and APOE genotype were obtained at baseline from 258 cognitively normal participants (mean age 57.2 years), who have now been followed for up to 17 years with annual clinical and cognitive assessments. Over time, approximately 60 participants have developed MCI or dementia, as determined by annual consensus diagnoses. A CR index was created, using the National Adult Reading Test (NART), WAIS-R vocabulary, and years of education. Cox regression models (adjusted by baseline age and gender) examined the interaction of CR with APOE-4 and APOE-2 status (present/absent). Age of onset of clinical symptoms was the outcome variable in these models. Results: Presence of an APOE-4 allele more than doubled the risk of developing clinical symptoms (RR¼2.52). Higher levels of CR decreased risk of progression by more than 50% (p < 0.0001; RR¼0.42). However, there was a significant interaction between APOE-2 genetic status and level of CR (p < 0.02; RR¼0.35), such that the presence of an APOE-2 allele was primarily protective in individuals with high but not low CR. Conclusions: The APOE-4 finding suggests that individuals with an APOE-4 allele may benefit from activities that promote CR, regardless of whether CR levels are high or low. The APOE-2 result suggests that individuals with an APOE-2 allele may disproportionately benefit from engaging in cognitively stimulating activities.
ORAL SESSIONS: O1-05 PUBLIC HEALTH AND PSYCHOSOCIAL FOCUS: EPIDEMIOLOGY I—CARDIOVASCULAR RISKS O1-05-01
LONG-TERM PATTERNS OF LOW PHYSICAL ACTIVITY AND COGNITIVE FUNCTION IN MIDLIFE: THE CARDIA STUDY
Tina Hoang1, Alain Koyama2, Deborah Barnes3, Steve Sidney4, David Jacobs5, Na Zhu5, Jared Reis6, Lenore Launer7, Rachel Whitmer4, Kristine Yaffe3, 1NCIRE, San Francisco, California, United States; 2 University of California, San Francisco/SF VA Medical Center, San Francisco, California, United States; 3University of California, San Francisco, San Francisco, California, United States; 4Kaiser Permanente Division of Research, Oakland, California, United States; 5University of Minnesota, Minneapolis, Minnesota, United States; 6National Heart, Lung,
Oral Sessions: O1-05: Public Health and Psychosocial Focus: Epidemiology I—Cardiovascular Risks and Blood Institute, Bethesda, Maryland, United States; 7National Institute on Aging, Bethesda, Maryland, United States. Contact e-mail: tina.hoang@ va.gov Background: Few studies have investigated whether physical activity in early to mid-life is associated with cognitive function even though this may be a critical period for establishing life-long activity habits. We investigated the relationship between long-term patterns of low physical activity over 25 years with cognitive function in mid-life. Methods: In a biracial cohort of 3,375 adults, (ages 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-86) and followed for 25 years, physical activity was assessed at repeated visits (3 assessments) using a validated physical activity questionnaire and cognitive function was evaluated at the end of follow-up, Year 25. A long-term pattern of low physical activity over 25 years was defined as reporting activity levels within the bottom tertile (<247 exercise units) of baseline physical activity scores for >2/3 rds of completed visits. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST, standard deviation (SD)¼16.16), Stroop Interference Score (SD¼10.98), and Rey Auditory Verbal Learning Test (RAVLT, SD¼3.27). Results: 26% of participants reported a long-term pattern of low physical activity over 25 years. Compared to more active participants, long-term patterns of low physical activity were associated with increased likelihood of significant poor cognitive performance (<1 SD below the mean) on DSST (inactive: 19% vs active: 15%, OR¼1.67, 95% CI 1.30-2.13) and Stroop (inactive: 18% vs active: 11%, OR¼1.47, 95% CI 1.15-1.88) but not on RAVLT, after adjusting for age, race, sex, education, smoking, body mass index, and hypertension. For those with very-low activity patterns (long-term pattern of physical activity scores <50 exercise units, 2% of participants), effects were even more pronounced (DSST: OR¼2.52, 95% CI 1.34-4.75; Stroop: OR¼2.24, 95% CI 1.21-4.14). Conclusions: Beginning in early adulthood, long-term patterns of low physical activity over 25 years were associated with worse mid-life executive function and processing speed. Future prevention strategies should focus on increasing physical activity across the life course. O1-05-02
CARDIOVASCULAR RISK FACTORS FOR COGNITIVE FUNCTION: EFFECTS FROM EARLY ADULTHOOD TO MID-LIFE
Kristine Yaffe1, Eric Vittinghoff1, Mark Pletcher1, Tina Hoang2, Lenore Launer3, Rachel Whitmer4, Laura5, Steve Sidney6, 1University of California, San Francisco, San Francisco, California, United States; 2 NCIRE, San Francisco, California, United States; 3National Institute on Aging, Bethesda, Maryland, United States; 4Kaiser Permanente Division of Research, Oakland, California, United States; 5Wake Forest School of Medicine, Winston-Salem, North Carolina, United States; 6Kaiser Permanente Northern California, Oakland, California, United States. Contact e-mail: [email protected] Background: Most studies investigating the relationship between cardiovascular risk factors (CVRFs) and cognitive function have focused on mid to late-life exposures, but little is known about this association starting from early adulthood and few have considered the cumulative effects of individual CVRFs over time. We investigated the relationship between cumulative burden of CVRFs from early to middle adulthood and cognitive function. Methods: In a prospective, biracial cohort of 3,498 adults, ages 18 to 30, enrolled in the CARDIA Study and followed for 25 years, cumulative exposure to fasting blood glucose, triglycerides, low and high density lipoproteins (LDL and HDL), and resting systolic and diastolic blood pressure (SBP and DBP) were estimated by areas under the curve (AUCs). Cognitive function at the Year 25 visit was assessed with the Digit Symbol Substitution Test (DSST), the Stroop Test, and Rey Auditory Verbal Learning Test (RAVLT) and analyzed with standardized z scores. Results: At Year 25, participant mean age was 50.2 (SD¼3.6), 46.9% were Black, and 43.4% were male. We found consistent associations for glucose, SBP, DBP, and triglycerides for all cognitive test domains after
P135
adjusting for age, race, gender, education, diabetes, smoking, and body mass index. For example, cognitive test z scores were between 0.08 and 0.10 points less for each standard deviation (SD) of glucose AUC, between 0.07 and 0.10 points less for SBP, between 0.06 and 0.07 points less for DBP, and between 0.04 and 0.05 points less for each SD of triglyceride AUC; p<0.05 for all. Few significant associations were observed for the cumulative effects of LDL or HDL. For most CVRFs, there was an association with cognitive function for both early (age<35) and middle adulthood (age>35) but the magnitude of the effects was small. Conclusions: Cumulative exposure of CVRFs from early to middle adulthood was associated with worse cognitive function in mid-life. Treatment of cardiovascular risk factors in early and mid-life and its effects on cognitive function need to be investigated.
O1-05-03
ACCORDANCE TO DIETARY APPROACHES TO STOP HYPERTENSION (DASH) IS ASSOCIATED WITH SLOWER COGNITIVE DECLINE
Christy Tangney1, Hong Li2, Lisa L. Barnes2, Julie Schneider3, David Bennett2, Martha Morris2, 1Rush University Medical Center, Arlington Heights, Illinois, United States; 2Rush University Medical Center, Chicago, Illinois, United States; 3Rush University Medical Center, Rush Alzheimer’s Disease Center, Chicago, Illinois, United States. Contact e-mail: [email protected] Background: The DASH (Dietary Approach to Stop Hypertension) diet has been shown to be protective against hypertension and diabetes, conditions that have also been shown to increase cognitive decline. The DASH diet is characterized by high consumption of fruits, vegetables, whole grains, nuts/seeds/legumes, lean meats/fish/poultry, lowor non-fat dairy and low consumption of sweets and of sodium. We examined whether accordance to a DASH plan is associated with slower cognitive decline in a prospective cohort study of persons 65 years and older. Methods: The sample was comprised of participants of the Memory and Aging Project (MAP) who agreed to complete a 144-item food frequency questionnaire (FFQ) (80% of surviving participants). A summary score (0-10) of accordance to the DASH diet was computed based on the assessment of the 8 dietary components above plus % energy from total fat and from saturated fat. A higher score reflects perfect DASH accordance. In annual neurological examinations, MAP participants’ global cognitive function was assessed with a battery of 19 cognitive tests. Global cognitive scores were computed by averaging the z-scores of the individual tests. Analyses were performed on a sample of 823 participants who completed a FFQ and had undergone 2 or more cognitive assessments. The median time of follow-up was 4 years. Results: The mean global cognitive score at baseline was 0.14 (range: -3.24 to 1.61), and the overall mean change in score per year was a decline of -0.08 standardized units. The mean DASH score was 4.0 6 1.3 with a range from 1.5 to 8.5. In mixed models adjusted for age, sex, race, and education, the DASH diet score was positively associated with slower rate of cognitive decline. Per 1-unit change in DASH score the decline rate was slower by 0.010 standardized units (SE¼0.004; p¼0.006). Conclusions: These data support the hypothesis that the DASH diet characterized by high consumption of vegetables, fruits, whole grains, lean meats, poultry and fish and low in sweets and sodium is associated with a slower rate of cognitive decline in older persons.
O1-05-04
REDUCED HEART RATE VARIABILITY IS ASSOCIATED WITH WORSE COGNITIVE FUNCTION IN ELDERLY MEXICAN-AMERICANS
Adina Zeki Al Hazzouri, Mary Haan, University of California San Francisco, San Francisco, California, United States. Contact e-mail: adina. [email protected]
Oral Sessions: O1-05: Public Health and Psychosocial Focus: Epidemiology I—Cardiovascular Risks
210 CN individuals (Clinical Dementia Rating Scale ¼ 0) who underwent clinical assessment and PiB-PET imaging. Cortical PiB retention was evaluated using a distribution volume ratio (DVR), using cerebellar cortex as tissue reference. SCC was measured by three questionnaires: the Everyday Cognition Scale, the Memory Functioning Questionnaire, and several questions from the Structured Telephone Interview for Dementia Assessment. A composite of SCC-M and SCC-E items were calculated respectively. A composite of verbal intelligence (AMNART IQ) and the Hollingshead scale was used as a proxy for cognitive reserve (CR). Subjects were classified as either low or high CR based on a median split of their composite score. Multivariate models related PiB retention to SCC-M and SCC-E for the low and high reserve groups. Results: Higher PiB retention was associated with greater SCC-M in both high and low reserve groups (High: b ¼0.98, p¼0.006; Low: b ¼1.12, p¼0.013). By contrast, there was a relationship between PiB and SCC-E for the high reserve group (b ¼0.95, p¼0.010), but not the low reserve group (b ¼0.23, p¼0.554). Conclusions: We found a relationship between SCC-M and amyloid burden at all levels of cognitive reserve. However, the relationship between SCC-E and amyloid burden appears more complex, with level of cognitive reserve modulating this relationship. Taken together, SCC-E, in addition to SCC-M, appears to be a potential indicator of early AD pathology, but may depend on level of cognitive reserve.
O1-04-05
HIGH-PERFORMING OLDER ADULTS: COGNITIVE AND BRAIN CORRELATES
Miranka Wirth1, Grace Tang1, Sylvia Villeneuve1, Cindee Madison2, Hwamee Oh1, William Jagust1, 1University of California, Berkeley, Berkeley, California, United States; 2Helen Wills Neuroscience Institute, Berkeley, California, United States. Contact e-mail: miranka.wirth@ gmail.com Background: Older adults with high cognitive abilities are suggested to have relatively preserved brain structures. The aim of this study was to identity different patterns of cognition and their underlying brain correlates in cognitively normal older adults. In addition the parameters were compared to a group of young adults. Methods: Cognitive test data of 286 cognitively normal older individuals from the Berkeley Aging Cohort were included; 71 of these people underwent multi-modal neuroimaging (MRI and PIB-PET). 112 younger individuals were examined using the same cognitive tests; 48 of these subjects had MR imaging. First, a cluster analysis identified groups of older adults that showed similar patterns in age-adjusted executive and memory function composite measures. Higher older performers were compared to the other groups with regard to self-evaluated cognitive abilities and brain pathology of beta-amyloid burden, measured using PIB-PET and white matter lesions volumes. Second, structural correlates explaining variability in executive functions and memory were assessed in the older and younger individuals. Third, high older performers were compared in cognitive abilities and structural correlates to young individuals. Results: The cluster analysis indicated four groups in the older individuals: high performers with above-average executive functions and memory, overall low performers, and two mixed groups with either decreased executive or memory functions. High older performers (EF+M+) did not differ from the other groups in education, age, and beta-amyloid burden or white matter lesion volumes. However, they evaluated their own cognitive abilities as superior. Within the older group, higher executive functions correlated with thicker cortex throughout heteromodal regions; higher memory performance was associated with increased hippocampal volume. The correlative patterns were not seen in younger individuals. Although high older performers exhibited above-average cortical thickness, their cognitive abilities, cortical thickness and hippocampal volume were nevertheless reduced in comparison to younger adults. Conclusions: Higher executive and memory functions in older age are mainly associated with thicker cortex in distributed regions and larger hippocampal volume, but not reduced brain pathology. The absence of the correlative relationships in the young and the age-related differences in cognitive functions
and structural correlates suggest differential aging in the elders as opposed to developmental differences.
O1-04-06
RELATIONSHIP OF COGNITIVE RESERVE AND APOE STATUS TO CLINICAL SYMPTOM ONSET OF MILD COGNITIVE IMPAIRMENT: THE BIOCARD COHORT
Anja Soldan1, Corinne Pettigrew1, Mei-Cheng Wang2, Shanshan Li2, Yi Lu2, Marilyn Albert3, Ola Selnes1, 1Johns Hopkins School of Medicine, Baltimore, Maryland, United States; 2Johns Hopkins School of Public Health, Baltimore, Maryland, United States; 3Johns Hopkins University, Baltimore, Maryland, United States. Contact e-mail: [email protected] Background: The primary genetic risk factor for late-onset AD is the apolipoprotein E epsilon-4 (APOE-4) allele, which is thought to increase the risk of AD by decreasing the clearance of amyloid from the brain. The APOE epsilon-2 (APOE-2) allele, by comparison, decreases the risk of developing AD dementia. Possession of one or two APOE-4 alleles, however, is neither necessary nor sufficient for developing AD dementia and possession of one or two APOE-2 alleles does not prevent dementia. Methods: This study examined the extent to which cognitive reserve (CR) modifies the association between APOE status and the risk of developing clinical symptoms preceding MCI. CR is a theoretical construct proposing that differences in lifetime experiences, such as more education and cognitive activity, may permit individuals to sustain greater levels of brain pathology before showing clinical symptoms. Measures of cognitive reserve and APOE genotype were obtained at baseline from 258 cognitively normal participants (mean age 57.2 years), who have now been followed for up to 17 years with annual clinical and cognitive assessments. Over time, approximately 60 participants have developed MCI or dementia, as determined by annual consensus diagnoses. A CR index was created, using the National Adult Reading Test (NART), WAIS-R vocabulary, and years of education. Cox regression models (adjusted by baseline age and gender) examined the interaction of CR with APOE-4 and APOE-2 status (present/absent). Age of onset of clinical symptoms was the outcome variable in these models. Results: Presence of an APOE-4 allele more than doubled the risk of developing clinical symptoms (RR¼2.52). Higher levels of CR decreased risk of progression by more than 50% (p < 0.0001; RR¼0.42). However, there was a significant interaction between APOE-2 genetic status and level of CR (p < 0.02; RR¼0.35), such that the presence of an APOE-2 allele was primarily protective in individuals with high but not low CR. Conclusions: The APOE-4 finding suggests that individuals with an APOE-4 allele may benefit from activities that promote CR, regardless of whether CR levels are high or low. The APOE-2 result suggests that individuals with an APOE-2 allele may disproportionately benefit from engaging in cognitively stimulating activities.
ORAL SESSIONS: O1-05 PUBLIC HEALTH AND PSYCHOSOCIAL FOCUS: EPIDEMIOLOGY I—CARDIOVASCULAR RISKS O1-05-01
LONG-TERM PATTERNS OF LOW PHYSICAL ACTIVITY AND COGNITIVE FUNCTION IN MIDLIFE: THE CARDIA STUDY
Tina Hoang1, Alain Koyama2, Deborah Barnes3, Steve Sidney4, David Jacobs5, Na Zhu5, Jared Reis6, Lenore Launer7, Rachel Whitmer4, Kristine Yaffe3, 1NCIRE, San Francisco, California, United States; 2 University of California, San Francisco/SF VA Medical Center, San Francisco, California, United States; 3University of California, San Francisco, San Francisco, California, United States; 4Kaiser Permanente Division of Research, Oakland, California, United States; 5University of Minnesota, Minneapolis, Minnesota, United States; 6National Heart, Lung,
Oral Sessions: O1-05: Public Health and Psychosocial Focus: Epidemiology I—Cardiovascular Risks and Blood Institute, Bethesda, Maryland, United States; 7National Institute on Aging, Bethesda, Maryland, United States. Contact e-mail: tina.hoang@ va.gov Background: Few studies have investigated whether physical activity in early to mid-life is associated with cognitive function even though this may be a critical period for establishing life-long activity habits. We investigated the relationship between long-term patterns of low physical activity over 25 years with cognitive function in mid-life. Methods: In a biracial cohort of 3,375 adults, (ages 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-86) and followed for 25 years, physical activity was assessed at repeated visits (3 assessments) using a validated physical activity questionnaire and cognitive function was evaluated at the end of follow-up, Year 25. A long-term pattern of low physical activity over 25 years was defined as reporting activity levels within the bottom tertile (<247 exercise units) of baseline physical activity scores for >2/3 rds of completed visits. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST, standard deviation (SD)¼16.16), Stroop Interference Score (SD¼10.98), and Rey Auditory Verbal Learning Test (RAVLT, SD¼3.27). Results: 26% of participants reported a long-term pattern of low physical activity over 25 years. Compared to more active participants, long-term patterns of low physical activity were associated with increased likelihood of significant poor cognitive performance (<1 SD below the mean) on DSST (inactive: 19% vs active: 15%, OR¼1.67, 95% CI 1.30-2.13) and Stroop (inactive: 18% vs active: 11%, OR¼1.47, 95% CI 1.15-1.88) but not on RAVLT, after adjusting for age, race, sex, education, smoking, body mass index, and hypertension. For those with very-low activity patterns (long-term pattern of physical activity scores <50 exercise units, 2% of participants), effects were even more pronounced (DSST: OR¼2.52, 95% CI 1.34-4.75; Stroop: OR¼2.24, 95% CI 1.21-4.14). Conclusions: Beginning in early adulthood, long-term patterns of low physical activity over 25 years were associated with worse mid-life executive function and processing speed. Future prevention strategies should focus on increasing physical activity across the life course. O1-05-02
CARDIOVASCULAR RISK FACTORS FOR COGNITIVE FUNCTION: EFFECTS FROM EARLY ADULTHOOD TO MID-LIFE
Kristine Yaffe1, Eric Vittinghoff1, Mark Pletcher1, Tina Hoang2, Lenore Launer3, Rachel Whitmer4, Laura5, Steve Sidney6, 1University of California, San Francisco, San Francisco, California, United States; 2 NCIRE, San Francisco, California, United States; 3National Institute on Aging, Bethesda, Maryland, United States; 4Kaiser Permanente Division of Research, Oakland, California, United States; 5Wake Forest School of Medicine, Winston-Salem, North Carolina, United States; 6Kaiser Permanente Northern California, Oakland, California, United States. Contact e-mail: [email protected] Background: Most studies investigating the relationship between cardiovascular risk factors (CVRFs) and cognitive function have focused on mid to late-life exposures, but little is known about this association starting from early adulthood and few have considered the cumulative effects of individual CVRFs over time. We investigated the relationship between cumulative burden of CVRFs from early to middle adulthood and cognitive function. Methods: In a prospective, biracial cohort of 3,498 adults, ages 18 to 30, enrolled in the CARDIA Study and followed for 25 years, cumulative exposure to fasting blood glucose, triglycerides, low and high density lipoproteins (LDL and HDL), and resting systolic and diastolic blood pressure (SBP and DBP) were estimated by areas under the curve (AUCs). Cognitive function at the Year 25 visit was assessed with the Digit Symbol Substitution Test (DSST), the Stroop Test, and Rey Auditory Verbal Learning Test (RAVLT) and analyzed with standardized z scores. Results: At Year 25, participant mean age was 50.2 (SD¼3.6), 46.9% were Black, and 43.4% were male. We found consistent associations for glucose, SBP, DBP, and triglycerides for all cognitive test domains after
P135
adjusting for age, race, gender, education, diabetes, smoking, and body mass index. For example, cognitive test z scores were between 0.08 and 0.10 points less for each standard deviation (SD) of glucose AUC, between 0.07 and 0.10 points less for SBP, between 0.06 and 0.07 points less for DBP, and between 0.04 and 0.05 points less for each SD of triglyceride AUC; p<0.05 for all. Few significant associations were observed for the cumulative effects of LDL or HDL. For most CVRFs, there was an association with cognitive function for both early (age<35) and middle adulthood (age>35) but the magnitude of the effects was small. Conclusions: Cumulative exposure of CVRFs from early to middle adulthood was associated with worse cognitive function in mid-life. Treatment of cardiovascular risk factors in early and mid-life and its effects on cognitive function need to be investigated.
O1-05-03
ACCORDANCE TO DIETARY APPROACHES TO STOP HYPERTENSION (DASH) IS ASSOCIATED WITH SLOWER COGNITIVE DECLINE
Christy Tangney1, Hong Li2, Lisa L. Barnes2, Julie Schneider3, David Bennett2, Martha Morris2, 1Rush University Medical Center, Arlington Heights, Illinois, United States; 2Rush University Medical Center, Chicago, Illinois, United States; 3Rush University Medical Center, Rush Alzheimer’s Disease Center, Chicago, Illinois, United States. Contact e-mail: [email protected] Background: The DASH (Dietary Approach to Stop Hypertension) diet has been shown to be protective against hypertension and diabetes, conditions that have also been shown to increase cognitive decline. The DASH diet is characterized by high consumption of fruits, vegetables, whole grains, nuts/seeds/legumes, lean meats/fish/poultry, lowor non-fat dairy and low consumption of sweets and of sodium. We examined whether accordance to a DASH plan is associated with slower cognitive decline in a prospective cohort study of persons 65 years and older. Methods: The sample was comprised of participants of the Memory and Aging Project (MAP) who agreed to complete a 144-item food frequency questionnaire (FFQ) (80% of surviving participants). A summary score (0-10) of accordance to the DASH diet was computed based on the assessment of the 8 dietary components above plus % energy from total fat and from saturated fat. A higher score reflects perfect DASH accordance. In annual neurological examinations, MAP participants’ global cognitive function was assessed with a battery of 19 cognitive tests. Global cognitive scores were computed by averaging the z-scores of the individual tests. Analyses were performed on a sample of 823 participants who completed a FFQ and had undergone 2 or more cognitive assessments. The median time of follow-up was 4 years. Results: The mean global cognitive score at baseline was 0.14 (range: -3.24 to 1.61), and the overall mean change in score per year was a decline of -0.08 standardized units. The mean DASH score was 4.0 6 1.3 with a range from 1.5 to 8.5. In mixed models adjusted for age, sex, race, and education, the DASH diet score was positively associated with slower rate of cognitive decline. Per 1-unit change in DASH score the decline rate was slower by 0.010 standardized units (SE¼0.004; p¼0.006). Conclusions: These data support the hypothesis that the DASH diet characterized by high consumption of vegetables, fruits, whole grains, lean meats, poultry and fish and low in sweets and sodium is associated with a slower rate of cognitive decline in older persons.
O1-05-04
REDUCED HEART RATE VARIABILITY IS ASSOCIATED WITH WORSE COGNITIVE FUNCTION IN ELDERLY MEXICAN-AMERICANS
Adina Zeki Al Hazzouri, Mary Haan, University of California San Francisco, San Francisco, California, United States. Contact e-mail: adina. [email protected]