Key result
Increased coronary artery calcium severity was associated with worse working memory performance, independent of cardiovascular risk factors, particularly in adults aged 45 to 54 years.
Why the study?
It was unknown whether increased coronary artery calcium severity is associated with worse cognitive function independently of cardiovascular risk factors in a general population with a broad age range.
Is increased severity of coronary artery calcium associated with worse cognitive function in adults without a history of cardiovascular disease?
Cross-Sectional (n=4,988)
Is increased severity of coronary artery calcium associated with worse cognitive function in adults without a history of cardiovascular disease?
Increased coronary artery calcium severity is independently associated with worse working memory in middle-aged adults without clinical cardiovascular disease, suggesting a link between subclinical atherosclerosis and early cognitive decline.
CAC severity linked to midlife working memory deficits; hypothesis-generating for vascular-cognitive links, needing longitudinal confirmation before clinical use.
Background The aim of this study was to investigate whether increased severity of coronary artery calcium (CAC), an imaging biomarker of subclinical coronary atherosclerosis, is associated with worse cognitive function independent of cardiovascular risk factors in a large population-based Dutch cohort with broad age range. Methods and Results A cross-sectional analysis was performed in 4988 ImaLife participants (aged 45-91 years, 58.3% women) without history of cardiovascular disease. CAC scores were obtained using nonenhanced cardiac computed tomography scanning. The CogState Brief Battery was used to assess 4 cognitive domains: processing speed, attention, working memory, and visual learning based on detection task, identification task, 1-back task, and 1-card-learning task, respectively. Differences in mean scores of each cognitive domain were compared among 4 CAC categories (0, 1-99, 100-399, ≥400) using analysis of covariates to adjust for classical cardiovascular risk factors. Age-stratified analysis (45-54, 55-64, and ≥65 years) was performed to assess whether the association of CAC severity with cognitive function differed by age. Overall, higher CAC was associated with worse performance on 1-back task after adjusting for classical cardiovascular risk factors, but CAC was not associated with the other cognitive tasks. Age-stratified analyses revealed that the association of CAC severity with working memory persisted in participants aged 45 to 54 years, while in the elderly this association lost significance. Conclusions In this Dutch population of ≥45 years, increased CAC severity was associated with worse performance of working memory, independent of classical cardiovascular risk factors. The inverse relationship of CAC score categories with working memory was strongest in participants aged 45 to 54 years.
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Xia et al. (2021) conducted a cross-sectional in Without history of cardiovascular disease (n=4,988). Increased coronary artery calcium (CAC) severity vs. Lower or zero CAC scores was evaluated on Cognitive function across 4 domains (processing speed, attention, working memory, and visual learning). Increased coronary artery calcium severity was associated with worse working memory performance, independent of cardiovascular risk factors, particularly in adults aged 45 to 54 years.
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