Subclinical Atherosclerosis and Cognitive Functioning in a Population-Based Sample

Clinical risk factors for and signs of atherosclerosis have been linked to Alzheimer disease and milder forms of cognitive impairment. This study examines the relationship between subclinical atherosclerosis and cognition in a sample from the Dallas Heart Study (DHS), a population-based study of cardiovascular disease, who were followed 8 years later (DHS-II); N = 1904, mean age = 42.9, SD = 10.5, range 8-65. Weanalyzed atherosclerosis data from DHS-I participants who had completed the Montreal Cognitive Assessment (MoCA) in DHS-II. The relationship between MoCA scores, coronary artery calcium (CAC), abdominal aortic plaque, and abdominal aortic wall thickness (AWT) was examined in the group as a whole, and in relation to age and ApoE4 allele status. Indirect measures of atherosclerosis (diabetes, hypertension, hypercholesterolemia, abdominal obesity) were also examined. Logistic regression was used to examine the association between direct and indirect measures of subclinical atherosclerosis and cognitive function, adjusting for other correlates of cognition. CAC (N = 1414, rho = -.06), abdominal AWT (N = 1284, rho = -.04), and abdominal aortic plaque (N = 1286, rho = -.06) did not correlate with MoCA Total Score (p ≥.048). Though MoCA scores were successively lower with increasing numbers of both direct atherosclerotic indicators [F(2, 633) = 1.40)] and indirect atherosclerotic indicators [F(2, 1048) = 1.09], the differences were not significant (p ≥ .248).The factors that most related to lower MoCA performance were race, gender, and education. There was no difference in MoCA Total Scores or measures of atherosclerosis between participants with an E4 allele and those without the E4 allele. There was no significant relationship between positive CAC, elevated abdominal AWT, and abdominal aortic plaque to MoCA scores obtained 7-8 years later. This relationship did not significantly increase with age and was not influenced by the presence of one or more apolipoprotein E4 alleles. This study does not support an association between direct or indirect measures of atherosclerosis in middle age and global cognition assessed 8 years later in this ethnically diverse population-based sample.