A comparative study of cardiovascular risk factors and its impact on cognitive function in rural and urban Indian cohorts

Abstract

AbstractBackgroundThe Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score is used to assess the future risk of developing dementia based on cardiovascular risk factors. In this study, we compared the cognitive functions of participants with higher and lower risk of dementia assessed using CAIDE score, in the rural and urban Indian populations. Data was obtained from participants enrolled in the TATA Longitudinal Study of Aging (TLSA) and Srinivaspura Aging, Neuro Senescence, and COGnition (SANSCOG) study, which are two large, harmonized studies from urban and rural India, respectively.MethodsThe clinical and blood biochemistry data from rural (n = 2005) and urban (n = 291) participants were used to estimate the CAIDE score and classify participants as high risk (score ≥ 9) and low risk of dementia (score < 9). The neuropsychological evaluation was performed using COGNITO battery, a computerized neuropsychometric platform that tests five cognitive domains. The cognitive scores of the high‐risk and the low‐risk groups were compared.ResultsThe rural cohort, compared to the urban cohort, had a lower proportion of people with formal education ≥10 years (17.0% vs. 99.3%), age above 54 years (63.5% vs. 90.8%), systolic BP > 140 mm Hg (10.1% vs. 33.7%) and BMI >30 kg/m2 (6.6% vs. 20.9%). The proportion of people with higher total cholesterol, gender distribution, and physical activity was comparable in both cohorts.On risk stratification, the high‐risk category comprised 26.34% of the rural and 9.46% of the urban cohort. The participants belonging to the high‐risk category from the rural cohort performed poorly in all cognitive domains, compared to the low‐risk category. In the urban cohort, there was no significant difference between both groups.ConclusionThe rural population had a higher proportion of people at high risk of dementia in the future, despite the younger age and lower proportion of participants with higher systolic BP and BMI. It seems that the lack of formal education may be primarily responsible for higher CAIDE scores in the rural population. Their baseline neuropsychological profile probably forecasts the possibility of cognitive dysfunction in the future. Interventions may help modify the cardiovascular risk factors and decrease the future burden of dementia.