Brain health index as a predictor of possible vascular cognitive impairment (pVCI) in the Mexican Health and Aging Study (MHAS) 2012‐2015

Abstract

AbstractBackgroundVascular dementia is the second most common cause of dementia. Brain health is defined as the capacity to function adaptively in the environment, and its partially determined by cardiovascular risk factors, which are a potential target for the prevention of all cause dementia. We developed a brain health index (BHI) to establish association with possible vascular cognitive impairment.MethodMHAS is a longitudinal cohort study of Mexican adults ≥50 years. The cardiovascular risk factors (CVRF) considered for the index were: diabetes, hypertension, myocardial infarction, depression, obesity, physical inactivity and smoking. pVCI was defined if scores in two or more cognitive domains in the Cross‐Cultural Cognitive Examination were ≥1.5 standard deviations below the mean on reference norms for self‐respondents or for proxy respondents a score ≥3.4 on the Informant Questionnaire on Cognitive Decline in the Elderly, with limitations in ≥1 instrumental activities of daily living and a history of stroke. A cognitive unimpaired and dementia without stroke groups were included. We compared the groups with ANOVA; a multinomial regression model was developed to predict the association of the BHI with the groups and a Cox regression model to determineResult12,427 individuals were included, 513 were identify as dementia without stroke and 75 as pVCI. For pVCI, 57.3% were female, with mean age of 75.28 (SD 9.31) years and education of 3.25 (SD 4.75) years. The mean BHI for the cohort was 2.21 (SD 1.27), for dementia without stroke 2.79 (SD 1.17), and with pVCI 3.28 (SD 1.23). The OR for pVCI was 1.904 (CI 1.4‐2.6, p <0.001) and the HR with a 3 year follow‐up was 1.75 (CI 1.4‐2.17, p <0.001).ConclusionThe BHI predicted the development of pVCI up to 74.5% in the 3 year follow‐up after adjusting for covariables. This index could potentially be used to identify pVCI in adults with potentially modifiable CVRF. Further studies should be carried out in other populations and with longer follow‐ups.