Key result
Subclinical arteriosclerosis and atherosclerosis are linked to accelerated cognitive decline and higher dementia risk over 20 years.
Why the study?
Subclinical cardiovascular disorders may be differentially associated with cognitive function, decline, and impairment, pointing to potential pathways linking vascular disorders to dementia.
Does higher subclinical vascular burden predict cognitive decline and impairment in adults free from clinical CVD?
Cohort (n=6,814)
Yes
Does higher subclinical vascular burden predict cognitive decline and impairment in adults free from clinical CVD?
Subclinical arteriosclerosis and atherosclerosis are associated with long-term cognitive decline and impairment independent of traditional clinical dementia risk scores.
Subclinical vascular scores may refine long-term cognitive risk models; leaves open whether targeting arteriosclerosis or atherosclerosis prevents decline.
INTRODUCTION: Subclinical cardiovascular disorders may be differentially associated with cognitive function, decline, and impairment and point to pathways linking vascular disorders to dementia. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) collected detailed subclinical vascular measures at baseline in 6814 participants with follow-up clinical examinations over 20 years. Baseline subclinical vascular measures aggregated into four uncorrelated factor composites: atherosclerosis, arteriosclerosis, blood pressure, and cardiac function. Cognitive performance was measured 10 years after baseline, repeated twice over the subsequent decade, along with detailed cognitive testing and adjudication. RESULTS: Higher baseline arteriosclerosis and atherosclerosis scores predicted greater cognitive decline, lower performance across multiple domains, and higher odds of mild cognitive impairment and dementia 20 years later. Associations were weaker for cardiac function and blood pressure composites. Stratified analyses confirmed generalizability across subgroups. DISCUSSION: Arteriosclerosis and atherosclerosis were more consistently associated with cognitive impairment and decline than cardiac function and blood pressure in a diverse population over 20 years. HIGHLIGHTS: Subclinical factor relationships varied by cognitive domain and race/ethnicity. These observed associations were independent of clinical risk for dementia. Arteriosclerosis most consistently associated with cognitive function and decline.
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Tanley et al. (2025) conducted a cohort in Cognitive decline and impairment (n=6,814). Subclinical vascular burden (arteriosclerosis and atherosclerosis) vs. Lower subclinical vascular burden was evaluated on Cognitive decline, domain-specific cognitive performance, and adjudicated cognitive impairment (MCI and dementia). Higher baseline subclinical arteriosclerosis and atherosclerosis scores were consistently associated with greater cognitive decline and higher odds of mild cognitive impairment and dementia over 20 years.
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