Early Life Vascular Risk Linked to Brain Pathology Later

A prospective longitudinal cohort study in Britain revealed that early adulthood vascular risk is strongly associated with smaller whole-brain volume (WBV) and greater white matter–hyperintensity volume (WMHV) at age 69 to 71 years. The study assessed 502 participants in a birth cohort in 1946. Framingham Heart study–cardiovascular risk scores (FHS-CVS) were derived at ages 36, 53, and 69 years, respectively. 463 participants (236 male) with at least 1 available imaging measure (mean age at imaging, 70.7 years; 83 β-amyloid positive) who fulfilled eligibility criteria were included. Among them, FHS-CVS increased with age (median 2.7%, 10.9%, and 24.3% for 36, 53, and 69 years, respectively). At all points, these scores were associated with smaller WBV (β coefficient per 1% increase, −3.6, −0.8, and −0.6 for 36, 53, and 69 years, respectively) and higher WMHV (exponentiated coefficient: 1.09, 1.02, and 1.01 for 36, 53, and 69 years, respectively), with largest effect sizes at age 36 years. At no point were FHS-CVS results associated with β-amyloid status. The findings are consistent with increasing evidence that vascular risk factors impact on an individual’s risk for developing dementia and suggest that reducing vascular risk with appropriate interventions should be considered from early adulthood for late-life brain health. Source: https://jamanetwork.com/