Comparison of Vascular Health in Super‐Agers and Cognitively Normal Adults 80 Years and Older

Abstract

AbstractBackgroundUnraveling factors associated with cognitive resilience and super‐agers might reduce expected increases in Alzheimer’s disease and related dementia (ADRD). Vascular disease can impair the cerebral circulation and increase risk for cognitive decline and ADRD. However, data in persons aged 80+ suggests that maintained vascular health can preserve key brain regions for normal cognition.MethodUsing National Alzheimer’s Coordinating Center (NACC) data from January 2005 ‐ December 2020, we found 9,581 participants age 80+ (white: 8,296 vs. AA: 1,285,p<.0001) at the baseline visit. We defined cognitive groups per global Clinical Dementia Rating (CDR) and Memory subscale scores. Normal cognition (NC) was defined as a global CDR and memory subscale score = 0. To identify super‐agers (SA), we utilized data‐derived cutoffs from cognitive test performances consistent with prior reports. The operationalized definition was created from: 1) Mean Craft delayed recall scores in 50–60‐year‐olds with NC; 2) Craft scores among age 80+ with NC group were standardized to the mean score for age 50‐60 with NC; and 3) Standardized mean scores for non‐memory measures (trail making test‐B, phonemic fluency, and multilingual naming test) for age 80+ with NC. SA were defined as age 80+ with episodic memory performance (Craft scores) ≥ 1 standard deviation (SD) of the standardized mean for the age 50‐60 group and non‐memory scores ≥ 1 SD of the standardized mean for the 80+ age group.ResultWe identified 4.5% (n = 431) SA and 27.7% (n = 2,654) NC (p<.01) to compare vascular variables. Compared to NC, SA were younger (83.5±3.4 vs. 84.7±4.0, p<.01), had more education (16.5±2.8 vs. 15.2±3.1, p<.01), higher diastolic blood pressure (DBP) (73.9±10.5 vs. 71.9±10.5, p<.01), and mean arterial pressure (MAP) (95.5±11.8 vs. 93.5±11.5, p<.01). Pulse pressure (PP) was similar for both groups (67.5±17.1 vs. 68.1±10.5, p = .33).ConclusionOur results suggest that vascular health could impact cognition in aged 80+ adults. SA may have higher cerebral perfusion (CP) per MAP. Although DBP can decrease with aging, higher values in our sample may contribute to CP. The PP in our sample is similar to reported values for healthy 70‐year‐old adults. Further study of vascular health and super‐aging is needed.