Abstract 13586: Association Between Subclinical Atherosclerosis and Midlife Cognitive Function: <i>The Bogalusa Heart Study</i>

Introduction: Alzheimer’s disease and related dementias (ADRD) are increasing in prevalence. While overt atherosclerosis is recognizable from childhood and has been linked to cognitive impairment and dementia in late life, information is scant on the association between subclinical atherosclerosis and cognitive impairment in midlife. We examined this observation in a cohort of middle-aged noninstitutionalized participants living in a semirural community. Hypothesis: Increased cIMT is associated with worse cognitive performance in midlife. Methods: The analysis included 1,217 participants (age 48 ± 5.28 years; 66% white, 58% women) of the Bogalusa Heart Study. Multivariable-adjusted regression models were used to determine the association between composite cIMT, dichotomized at the 50thpercentile, and a standardized global cognitive z-score (GCS), as well as individual cognitive domains z-scores. Results: The composite cIMT (>0.87mm) was inversely associated with GCS (B= -0.39, SE= 0.18, p = 0.03), independent of cardiovascular risk factors (CVRF’s) and education. (Table1) The cIMT-composite was independently associated with poorer episodic memory (B= -0.23, SE=0.10, p = 0.015). The effect remained significant in Black and White participants after adjustment for CVRF’s (Blacks:B= -0.45, SE: 0.17, p = 0.008; Whites: B= -0.29, SE= 0.13, p = 0.028), but not for education. Conclusions: Subclinical atherosclerosis, as assessed via cIMT, is associated with worse cognitive function in midlife, independent of major CVRFs. The association is buffered by education, and this effect may be stronger among black participants than white. These findings reinforce the importance of establishing preventive measures in midlife and suggest subclinical atherosclerosis as a potential target to prevent cognitive decline.