Among older adults, intermediate-to-favorable global cardiovascular health (CVH) profiles are associated with slower vascular brain aging, according to a study published in Neurology.
Researchers sought to explore the associations between CVH metrics and metabolic susceptibility genes with vascular brain aging, via an investigation of the following hypotheses:
- A favorable level of CVH metrics would be linked to a lower rate of vascular brain aging, in which the association may vary based on age;
- Higher genetic susceptibility to metabolic risk factors would be associated with a more rapid progression of vascular brain aging; and
- The link between higher metabolic genetic predisposition and vascular brain aging might be mitigated partially among individuals with a favorable level of CVH metrics.
For the study, all participants derived from the magnetic resonance imaging (MRI) substudy of the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K) — a multidisciplinary study of aging and health among individuals aged 60 years or older in the Kungsholmen district of Stockholm, Sweden. The current study comprised individuals who had undergone repeated brain MRI studies from 2001 to 2003 and from 2007 to 2020 (ie, volumes of white-matter hypersensitivity [WMH] and grey matter, count of perivascular spaces, and lacunes).
At baseline, global, behavioral, and biological metrics were defined and scored with use of the Life’s Simple 7 approach, which categorized them into unfavorable, intermediate, and favorable profiles, according to tertiles. Metabolic genetic risk score was computed by counting 15 risk alleles that are related to hypertension, dyslipidemia, and diabetes.
The study sample comprised a total of 317 participants from SNAC-K. Overall, 61.8% of the participants were women. The average age was aged 60 years or older.
The researchers found that favorable and intermediate (vs unfavorable) global CVH profiles were associated with slower WMH progression (β-coefficient, –0.019; 95% CI, –0.035 to –0.002 and β-coefficient, –0.018; 95% CI, –0.034 to –0.001, respectively). Further, each 1-point increment in biological CVH metric score was significantly associated with slower accumulation of WMH among individuals 60 to 72 years of age (β-coefficient, –0.007; 95% CI, –0.013 to –0.000; P =.042) but not among those aged 78 years or older (β-coefficient, 0.008; 95% CI, –0.004 to 0.019).
Additionally, a higher genetic metabolic risk score (range, 6 to 21) was associated with more rapid WMH increases (β-coefficient, 0.005; 95% CI, 0.003 to 0.008).
Statistical interactions were observed among genetic risk score and global and behavioral CVH profiles on WMH accumulation. A higher metabolic risk score was associated with faster WMH accumulation among individuals with unfavorable (β-coefficient, 0.015; 95% CI, 0.007 to 0.023), intermediate (β-coefficient, 0.005; 95% CI, 0.001 to 0.009), and favorable (β-coefficient, 0.003; 95% CI, –0.001 to 0.006) global CVH profiles.
With respect to behavioral CVH profiles, the corresponding values were as follows: unfavorable (β-coefficient, 0.013; 95% CI, 0.006 to 0.020), intermediate (β-coefficient, 0.006; 95% CI, 0.003 to 0.009), and favorable (β-coefficient, 0.002; 95% CI, –0.002 to 0.006).
Limitations of the current study should be noted. The lack of composite CVH profiles at follow-ups did not permit the researchers to examine the relationship between dynamic CVH profiles and brain aging. Additionally, certain markers of vascular brain imaging were not available because of a lack of relevant MRI sequences or limited imaging resolution.
The researchers concluded that “These findings highlight the importance of adhering to favorable CVH profiles, especially healthy behaviors, in vascular brain health.”
Li Y, Laukka EJ, Dekhtyar S, et al. Association between behavioral, biological, and genetic markers of cardiovascular health and MRI markers of brain aging: a cohort study. Neurology. Published online November 1, 2022. doi:10.1212/WNL.0000000000201346