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Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline
Debette S, Seshadri S, Beiser A, Au R, Himali JJ, Palumbo C, Wolf PA, DeCarli C.. Neurology, 2011-08-01
Topic: Risk, prevention and care in population studies
Objective Our aim was to test the association of vascular risk factor exposure in midlife with progression of MRI markers of brain aging and measures of cognitive decline. Methods A total of 1,352 participants without dementia from the prospective Framingham Offspring Cohort Study were examined. Multivariable linear and logistic regressions were implemented to study the association of midlife vascular risk factor exposure with longitudinal change in white matter hyperintensity volume (WMHV), total brain volume (TBV), temporal horn volume, logical memory delayed recall, visual reproductions delayed-recall (VR-d), and Trail-Making Test B-A (TrB-A) performance a decade later. Results Hypertension in midlife was associated with accelerated WMHV progression (p Conclusions Midlife hypertension, diabetes, smoking, and obesity were associated with an increased rate of progression of vascular brain injury, global and hippocampal atrophy, and decline in executive function a decade later.
Key findings
- Results Hypertension in midlife was associated with accelerated WMHV progression (p < 0.001) and worsening executive function (TrB-A score; p = 0.012).
Why it matters
In 1,352 people without dementia from the Framingham Offspring study, those with high blood pressure, diabetes, smoking or obesity in midlife showed faster growth of white-matter damage on MRI, faster shrinkage of the whole brain and hippocampus, and faster decline on a test of executive function about ten years later. These are associations from an observational study that measured brain scans and test scores, not dementia diagnoses, and it does not show that treating these risk factors prevents Alzheimer's disease.
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Study details
- Study designcohort study
- Participants1,352
- Evidence strengthModerate
How this study scored 72/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,352 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 | 6 / 7 | Cited 772 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 45.4 citations a year over 17 year(s) since 2011 |
| Impact for its field and year | 5 / 6 | Cited 25.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 44 other studies in this library |
| Still being cited | 3 / 4 | Cited 124 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Charles S DeCarli: h-index 150 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | National Institutes of Health: institution h-index 2,723 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21810696) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 72 / 100 | — |
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Read the original
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
Debette, S., Seshadri, S., Beiser, A., Au, R., Himali, J. J., Palumbo, C., et al. (2011). Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline. Neurology. https://doi.org/10.1212/wnl.0b013e318227b227
Vancouver
Debette S, Seshadri S, Beiser A, Au R, Himali JJ, Palumbo C, et al. Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline. Neurology. 2011. doi:10.1212/wnl.0b013e318227b227. PMID: 21810696.
BibTeX
@article{debette2011-21810696,
author = {Debette, S. and Seshadri, S. and Beiser, A. and Au, R. and Himali, J. J. and Palumbo, C. and Wolf, P. A. and DeCarli, C.},
title = {{Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline}},
journal = {Neurology},
year = {2011},
doi = {10.1212/wnl.0b013e318227b227},
pmid = {21810696},
url = {https://doi.org/10.1212/wnl.0b013e318227b227}
}
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