March 11, 2025JAMA Network Open9 citationsOpen Access
Cardiovascular Health and Biomarkers of Neurodegenerative Disease in Older Adults
Key Result
High cardiovascular health scores (10-14 points) were associated with significantly lower serum levels of neurofilament light chain compared to low scores (relative difference -18.9%).
Study Design
Type
Cohort (n=1,018)
Structured PICO
Does a higher cardiovascular health score reduce serum biomarkers of neurodegeneration in older adults?
P
Population
1,018 adults aged 65 years or older with measured serum NfL, t-tau levels, and CVH score components from the Chicago Health and Aging Project.
E
Exposure
High Cardiovascular Health (CVH) score (10-14 points based on Life's Simple 7 components: healthy diet, regular exercise, normal BMI, nonsmoking, absence of dyslipidemia, diabetes, and hypertension)
C
Comparator
Low Cardiovascular Health (CVH) score (0-6 points)
O
Outcome
Serum biomarkers of neurodegeneration (neurofilament light chain [NfL] and total tau [t-tau])surrogate
Higher cardiovascular health scores in older adults are associated with lower serum levels of neurofilament light chain and a slower age-related increase, suggesting a protective effect against neurodegeneration.
Main Result
Effect estimate: relative difference -18.9%
Abstract
Importance: Cardiovascular health (CVH), defined by the American Heart Association as Life's Simple 7 to promote a healthy lifestyle and manage vascular risk factors, has been associated with a low risk of Alzheimer disease and less vascular dementia. However, the association between CVH and biomarkers of neurodegeneration remains less understood. Objective: To investigate the association of CVH with serum biomarkers of neurodegeneration, including neurofilament light chain (NfL) and total tau (t-tau). Design, Setting, and Participants: This cohort study was conducted within the biracial, population-based Chicago Health and Aging Project (CHAP) of adults aged 65 years or older between 1993 and 2012. Participants who had measured serum NfL and t-tau levels and data on all components of the CVH score were included. The statistical analysis was conducted from April 10 to September 26, 2024. Exposure: The CVH score includes 7 components: a healthy diet; regular exercise; normal body mass index; nonsmoking status; and the absence of dyslipidemia, diabetes, and hypertension. The scores were divided into 3 groups from lowest to highest CVH (0-6 points, 7-9 points, and 10-14 points). Main Outcomes and Measures: The main outcome was the association of CVH score with serum biomarkers of NfL and t-tau as measured using linear regression and mixed-effects models. Results: A total of 1018 CHAP participants were included in the analysis (mean SD age, 73.1 6.1 years; 625 female 61.4%; 610 Black or African American 59.9% and 408 White 40.1%). Participants with a high CVH score (ie, 10-14 points) were predominantly White (151 64.3%) and had a higher education (mean SD, 13.6 3.7 years). Compared with participants with low CVH scores (ie, 0-6 points), those with CVH scores of 10 to 14 points had significantly lower serum levels of NfL (relative difference, -18.9%; β = -0.091; SE, 0.025). A higher CVH score was associated with a slower annual increase in NfL levels as participants aged (relative difference in rate, -1.7%; β = -0.008; SE, 0.004). Cardiovascular health was not associated with serum levels of t-tau. Conclusions and Relevance: These findings suggest that promoting CVH in older adults may help alleviate the burden of neurodegenerative diseases, particularly among Black adults, who are known to experience a higher prevalence of cardiovascular disease.