Distinct components of cardiovascular health are linked with age-related differences in cognitive abilities
Deborah L. O. King, Richard N. Henson, Rogier Kievit, Noham Wolpe, Carol Brayne, Lorraine K. Tyler, James B. Rowe, Cam-CAN, Edward T. Bullmore, Andrew C. Calder, Rhodri Cusack, Tim Dalgleish, John S. Duncan, Fiona E. Matthews, William D. Marslen‐Wilson, Meredith A. Shafto, Karen L. Campbell, Teresa Cheung, Simon W. Davis, Linda Geerligs, Anna McCarrey, Abdur Mustafa, Darren Price, Dávid Samu, Jason R. Taylor, Matthias S. Treder, Janna van Belle, Nitin Williams, Daniel J. Mitchell, Simon E. Fisher, Else Eising, Ethan Knights, Lauren Bates, Tina Emery, Sharon Erzinçlioğlu, Andrew Gadie, Sofia Gerbase, Stanimira Georgieva, Claire Hanley, Beth Parkin, David Troy, Tibor Auer, Marta Correia, Lu Gao, Emma Green, Rafael Neto Henriques, Jodie Allen, Gillian Amery, Liana Amuntse, Anne Barcroft, Amanda Castle, Cheryl Dias, Jonathan Dowrick, Melissa Fair, Hayley Fisher, Anna Goulding, Adarsh Grewale, G Hale, Andrew Hilton, Frances L. Johnson, Patricia Johnston, Thea Kavanagh-Williamson, Magdalena Kwaśniewska, Alison McMinn, Kim Norman, Jessica Penrose, Fiona Roby, Diane Rowland, John Sargeant, Maggie Squire, Beth Stevens, Aldabra Stoddart, Cheryl Stone, Tracy Thompson, Ozlem Yazlik, Dan Barnes, Marie Dixon, Jaya Hillman, Joanne Mitchell, Laura Villis, Kamen A. Tsvetanov
Abstract
Cardiovascular ageing contributes to cognitive impairment. However, the unique and synergistic contributions of multiple cardiovascular factors to cognitive function remain unclear because they are often condensed into a single composite score or examined in isolation. We hypothesized that vascular risk factors, electrocardiographic features and blood pressure indices reveal multiple latent vascular factors, with independent contributions to cognition. In a population-based deep-phenotyping study (n = 708, age 18-88), path analysis revealed three latent vascular factors dissociating the autonomic nervous system response from two components of blood pressure. These three factors made unique and additive contributions to the variability in crystallized and fluid intelligence. The discrepancy in fluid relative to crystallized intelligence, indicative of cognitive decline, was associated with a latent vascular factor predominantly expressing pulse pressure. This suggests that higher pulse pressure is associated with cognitive decline from expected performance. The effect was stronger in older adults. Controlling pulse pressure may help to preserve cognition, particularly in older adults. Our findings highlight the need to better understand the multifactorial nature of vascular aging.