Young adulthood cardiovascular risk and MRI and amyloid PET in late‐life in a diverse cohort: The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Abstract

AbstractBackgroundMid‐life cardiovascular (CVD) risk factors have been associated with cognitive impairment, but CVD risk factors in young adulthood are not well characterized. We evaluated how young adulthood CVD factors influence late‐life brain health in The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort.MethodKHANDLE is a multi‐ethnic study of 1,712 long‐term Kaiser Permanente North California members ages 65 and older. To date, 165 participants (25% Asian, 21% Black, 24% Latino, and 30% White) received MRI and PET imaging as part of an imaging sub‐study. MRI analyses included regional gray matter and total WMH volumes. Amyloid PET used AV45 and standard SUVR analysis with cerebellar gray matter as the reference region. Participants underwent neuropsychologic testing and received diagnoses of cognitively normal or dementia/mild cognitive impairment (MCI). CVD risk factors were measured during Multiphasic Health Checkups (MHC) between 1964‐1992 where body mass index (BMI), blood pressure, and total cholesterol were measured. The association of young adulthood CVD factors with imaging measures and syndrome were assessed using linear and logistic regressions with adjustment for age, years since MHC, gender, education and race/ethnicity.ResultParticipants had a mean age of 31+6 at MHC and 75+6 at KHANDLE. Being overweight or obese at MHC was negatively associated with hippocampal volume [β:‐0.42(‐0.81, ‐0.03)] and marginally associated with cerebral gray matter [β:‐0.37(‐0.75, 0.01)] and temporal cortex [β: ‐0.39(‐0.78, 0.01)] volumes. Continuous BMI was negatively associated with cerebral gray [β:‐0.07(‐0.14, ‐0.01)], hippocampal [β:‐0.07(‐0.14, ‐0.01)], and temporal cortex [β:‐0.39(‐0.78, 0.01)] volumes. Hypertension at MHC was negatively associated with cerebral [β:‐0.34(‐0.61, ‐0.06)] and occipital cortex [β:‐0.36(‐0.66, ‐0.06)] volumes. Hypercholesteremia at MHC was negatively associated with cerebral volume [β:‐0.50(‐0.81, ‐0.19)] and hippocampal volume [β:‐0.36(‐0.72, ‐0.01)]. A standard deviation increase in total cholesterol was negatively associated with hippocampal volume [β:‐0.16(‐0.31, ‐0.01)] and associated with greater amyloid burden [β:0.19(0.02, 0.36)].ConclusionCVD risk factors of overweight/obesity, hypertension, and hypercholesteremia in young adulthood were negatively associated with measures of late‐life brain health in this diverse cohort of community‐dwelling older adults.