Department of Radiology University of Groningen Groningen The Netherlands.
Department of Epidemiology University of Groningen Groningen The Netherlands.
J Am Heart Assoc. 2021 Feb 16;10(4):e018172. doi: 10.1161/JAHA.120.018172. Epub 2021 Feb 2.
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.
本研究旨在探讨在一个年龄范围广泛的大型荷兰人群队列中，作为亚临床冠状动脉粥样硬化的影像学生物标志物的冠状动脉钙化（CAC）严重程度增加是否与心血管危险因素以外的认知功能下降有关。
对 4988 名 ImaLife 参与者（年龄 45-91 岁，58.3%为女性）进行了横断面分析，这些参与者无心血管疾病病史。使用非增强心脏计算机断层扫描获得 CAC 评分。使用 CogState 简明电池评估 4 个认知领域：基于检测任务的处理速度、注意力、工作记忆和视觉学习，分别使用识别任务、1 回任务和 1 卡学习任务。使用协方差分析比较 4 个 CAC 类别（0、1-99、100-399、≥400）之间每个认知领域的平均得分差异，以调整经典心血管危险因素。进行年龄分层分析（45-54、55-64 和≥65 岁），以评估 CAC 严重程度与认知功能的关联是否因年龄而异。总体而言，在调整经典心血管危险因素后，CAC 越高与 1 回任务的表现越差相关，但 CAC 与其他认知任务无关。年龄分层分析显示，在 45 至 54 岁的参与者中，CAC 严重程度与工作记忆之间的关联仍然存在，而在老年人中这种关联失去了意义。
在≥45 岁的荷兰人群中，CAC 严重程度与工作记忆的表现下降有关，与经典心血管危险因素无关。CAC 评分类别与工作记忆之间的负相关关系在 45 至 54 岁的参与者中最强。
