DOI: 10.1161/jaha.125.048189 ISSN: 2047-9980

Association of Weighted Composite Score of Long‐Term Variability of Vascular Risk Factors From Childhood With Midlife Cognitive Function: The Bogalusa Heart Study

Soo Jung Kang, Jeanette Gustat, Wan Tang, Phillip H. Hwang, Owen T. Carmichael, Ileana De Anda‐Duran, Lydia A. Bazzano
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Background

Variability in vascular risk factors (VRFs) has been associated with dementia risk. Whether aggregate VRF variability from childhood influences midlife cognitive function (CF) is unclear.

Methods

Participants of the Bogalusa Heart Study with ≥3 measurements of VRFs (systolic blood pressure, fasting glucose, non‐HDL cholesterol, and BMI) from childhood to midlife and one midlife CF assessment were included. Long‐term VRF variability was measured using coefficient of variation. A weighted composite score (WCS) was constructed by regressing the global cognitive score (GCS) on VRF variability tertiles and using the coefficients as weights. The GCS, defined as the average of 8 age‐, race‐, and sex‐standardized neuropsychological test scores, represents overall CF. Each VRF variability tertile indicator was multiplied by its coefficient, and the products were summed to generate the WCS. Neuropsychological test scores were also classified into 3 neuropsychological profiles by test performance using cluster analysis as an alternative measure of midlife CF. Associations between WCS and neuropsychological profiles were evaluated using multinomial logistic regression.

Results

Among 1009 participants (mean age 48 years, 34% Black; 61% women), those in the highest WCS tertile had 134% higher odds of memory/executive function deficit neuropsychological profile versus the lowest tertile. When WCS was disaggregated, those in the highest glucose variability tertile had 79% and 72% greater odds of the attention/processing speed and memory/executive function deficit neuropsychological profiles, respectively, versus the lowest tertile.

Conclusions

Higher aggregate VRF variability from childhood may adversely influence midlife CF. Monitoring VRF variability earlier may help preserve brain health.

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