Abstract
Cardiometabolic diseases and risk factors increase the risk of late-life cognitive impairment and dementia and have also been associated with detrimental gray and white matter changes. However, the functional brain changes associated with cardiometabolic health in late-life are unclear. We sought to characterize these functional changes by recording event-related potentials (ERPs) during an n-back working memory task (0, 1, and 2 back) in 85 adults (60% female) between 50 and 80 years of age. Due to a stratified recruitment approach, participants varied widely in relation to cognitive function and cardiometabolic health. Standard and objective cut-offs for high blood glucose, waist to hip ratio (i.e., obesity), high blood cholesterol, and hypertension were employed to generate a summative score for cardiometabolic burden (none, one, or two or more above cut-off). Mixed effects modeling (covarying for age and gender) revealed no statistically significant associations between cardiometabolic burden and visual P1 and N1 component amplitudes. There was a significant effect for the P3b component: as cardiometabolic burden increased, P3b amplitude decreased. We show that cardiometabolic factors related to the development of cognitive impairment and dementia in late-life associate with brain activity, as recorded via ERPs. Findings have relevance for the monitoring of lifestyle interventions (typically targeting cardiometabolic factors) in aging, as ERPs may provide a more sensitive measure of change than cognitive performance. Further, our results raise questions related to the findings of a broad range of ERP studies where the groups compared may differ in their cardiometabolic health status (not only in psychological symptomatology).
Highlights
Cardiometabolic diseases and risk factors increase the risk of late-life cognitive impairments, including dementia [1, 2]
Mixed effects modeling revealed no significant effect of cardiometabolic burden (p = 0.922) nor interaction between cardiometabolic burden and difficulty (p = 0.719), on reaction times
When the accuracy of target detection was used as the outcome, there was a significant interaction between vascular burden and difficulty, which reflected that the number of correct hits to targets were lower in those with high cardiometabolic burden, but only when difficulty was high; there was no main effect of cardiometabolic burden (p = 0.207)
Summary
Cardiometabolic diseases and risk factors increase the risk of late-life cognitive impairments, including dementia [1, 2]. The greatest dementia risk is conveyed if these cardiometabolic factors are present in mid-life and early late-life, with null or paradoxical relationships seen in the oldest old, typically defined as those 85 years and over [3, 4]. How these cardiometabolic factors affect brain structure and function between mid- and latelife is the focus of current research, as it has been established that dementia-related pathologies accumulate decades before clinical symptoms [5]. In young to mid-adulthood, widespread cortical thinning has been shown to relate independently to two obesity measures: body mass index (BMI) and visceral adipose tissue [9]
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