Worse Cardiac Structure and Function is Associated with Decline in Multiple Domains of Cognitive Function: The Atherosclerosis Risk in Communities (ARIC) Study
Cognitive impairment is cross-sectionally correlated with worse cardiac structure/function. But limited data exist concerning cardiac structure/function and longitudinal changes in cognitive function. Dehghan A, presented a session held at the American Heart Association (AHA) from 16-18 November 2024, in Chicago, Illinois aimed to assess the correlation of cardiac structure and function with longitudinal changes in cognitive performance in late life.
Between HF- and dementia-free participants in the community-based ARIC study who attended the 5th study visit (V5; 2011-2013), gone through protocol echocardiography, and completed a neurocognitive test battery at both V5 and study Visit 6 (V6; 2015-17). A multivariable linear regression was used to evaluate correlations of cardiac structure and function measures with changes in both domain-specific and global cognitive scores between V5 and V6. The neuropsychological test battery comprised of 10 neuropsychological tests that covered 3 domains of cognitive function: memory, executive functioning, and language.
Between 2,988 included participants, mean age was 74±5 years, 60% were female, 20% reported Black race, and mean LVEF was 66±6%. Across a mean of 4.9±0.6 years (the V5 to V6 interval), raw scores decreased for all neuropsychological tests. In fully adjusted models, worse diastolic function (larger LAVi) and LV remodelling (greater LV mass index) were correlated with reduction in executive function. Lower LVEF was correlated with reduction in language function, although worse LV longitudinal strain – a more sensitive measure of systolic dysfunction – was correlated with reduction in executive function, language function, and global cognition performance (all p<0.05; Table).
Subclinical LV remodeling and dysfunction is correlated with higher reductions in cognitive function across 5 years in late life. Differential correlations were observed using cognitive domains, with executive function reduction most uniformly correlated with impairments in cardiac structure/function.