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Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline
Song R, Xu H, Dintica CS, Pan KY, Qi X, Buchman AS, Bennett DA, Xu W.. Journal of the American College of Cardiology, 2020-05-01
Topic: Risk, prevention and care in population studies
Background The impact of cardiovascular risk burden on cognitive trajectories and brain structure changes remains unclear. Objectives This study aimed to examine whether cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) is associated with cognitive decline and structural brain differences. Methods Within the Rush Memory and Aging Project, 1,588 dementia-free participants (mean age: 79.5 years) were followed for up to 21 years. FGCRS was assessed at baseline and categorized into tertiles (lowest, middle, and highest). Episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed were assessed annually with a battery of 19 tests, from which composite scores were derived. A subsample (n = 378) of participants underwent magnetic resonance imaging. Structural total and regional brain volumes were estimated. Data were analyzed using linear mixed-effects models and linear regression models. Results In all participants, FGCRS ranged from 4 to 28 (mean score: 15.6 ± 3.7). Compared with the lowest tertile of FGCRS, the highest tertile was associated with faster decline in global cognition (β = -0.019; 95% confidence interval [CI]: -0.035 to -0.003), episodic memory (β = -0.023; 95% CI: -0.041 to -0.004), working memory (β = -0.021; 95% CI: -0.035 to -0.007), and perceptual speed (β = -0.027; 95% CI: -0.042 to -0.011) over the follow-up. In magnetic resonance imaging data analyses, higher FGCRS was related to smaller volumes of the hippocampus (β = -0.021; 95% CI: -0.042 to -0.000), gray matter (β = -1.569; 95% CI: -2.757 to -0.382), and total brain (β = -1.588; 95% CI: -2.832 to -0.344), and greater volume of white matter hyperintensities (β = 0.035; 95% CI: 0.001 to 0.069). Conclusions Higher cardiovascular risk burden may predict decline in episodic memory, working memory, and perceptual speed and is associated with neurodegeneration and vascular lesions in the brain.
Key findings
- Objectives This study aimed to examine whether cardiovascular risk burden assessed by the Framingham General Cardiovascular Risk Score (FGCRS) is associated with cognitive decline and structural brain differences.
- Results In all participants, FGCRS ranged from 4 to 28 (mean score: 15.6 ± 3.7).
- Compared with the lowest tertile of FGCRS, the highest tertile was associated with faster decline in global cognition (β = -0.019; 95% confidence interval [CI]: -0.035 to -0.003), episodic memory (β = -0.023; 95% CI: -0.041 to -0.004), working memory (β = -0.021; 95% CI: -0.035 to -0.007), and perceptual speed (β = -0.027; 95% CI: -0.042 to -0.011) over the follow-up.
- Conclusions Higher cardiovascular risk burden may predict decline in episodic memory, working memory, and perceptual speed and is associated with neurodegeneration and vascular lesions in the brain.
Why it matters
In this long-term study, higher cardiovascular risk scores were associated with faster decline in global cognition, episodic memory, working memory, and perceptual speed. This suggests managing cardiovascular risk may be relevant to cognitive health, but the study does not prove that treating risk factors prevents Alzheimer's disease.
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Study details
- Participants378
- Evidence strengthLow
How this study scored 57/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American College of Cardiology) |
| Journal's citation record | 4 / 4 | Journal of the American College of Cardiology: journal h-index 618 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 378 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 212 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.5 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 4 / 6 | Cited 16.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 3 / 4 | Cited 107 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Weili Xu: h-index 57 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32439001) |
| Free to read | 2 / 2 | Free to read |
| Total | 57 / 100 | — |
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Read the original
- DOI: 10.1016/j.jacc.2020.03.053
- PubMed: 32439001
- Original source →
- Free full text: Journal of the American College of Cardiology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Song, R., Xu, H., Dintica, C. S., Pan, K. Y., Qi, X., Buchman, A. S., et al. (2020). Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2020.03.053
Vancouver
Song R, Xu H, Dintica CS, Pan KY, Qi X, Buchman AS, et al. Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline. Journal of the American College of Cardiology. 2020. doi:10.1016/j.jacc.2020.03.053. PMID: 32439001.
BibTeX
@article{song2020-32439001,
author = {Song, R. and Xu, H. and Dintica, C. S. and Pan, K. Y. and Qi, X. and Buchman, A. S. and Bennett, D. A. and Xu, W.},
title = {{Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline}},
journal = {Journal of the American College of Cardiology},
year = {2020},
doi = {10.1016/j.jacc.2020.03.053},
pmid = {32439001},
url = {https://doi.org/10.1016/j.jacc.2020.03.053}
}
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