Midlife Vascular Risk Factors Impact Structural Brain Aging

Hypertension, diabetes, smoking, obesity linked with increased vascular brain injury progression

MONDAY, Aug. 1 (HealthDay News) -- Hypertension, diabetes, smoking, and obesity in midlife are associated with accelerated progression of structural brain aging, and decline in executive function a decade later, according to a study published in the Aug. 2 issue of Neurology.

Stéphanie Debette, M.D., Ph.D., from the Boston University School of Medicine, and colleagues examined the association between midlife vascular risk factors and progression of magnetic resonance imaging markers of brain aging and cognitive decline in 1,352 patients without dementia. The association between risk-factor exposure and longitudinal change in white matter hyperintensity volume (WMHV), total brain volume (TBV), temporal horn volume, logical memory delayed recall, visual reproductions delayed recall, and Trail-Making Test B-A (TrB-A) performance a decade later was identified using multivariable linear and logistic regression.

The investigators found that hypertension in midlife was significantly associated with both accelerated WMHV progression and worsening executive function (TrB-A score). A rapid increase in temporal horn volume was significantly associated with both midlife diabetes and smoking. A significant decrease in TBV and increased risk of extensive change in WMHV (odds ratio [OR], 1.58) were correlated with midlife smoking. Midlife obesity was linked with a significantly increased risk of being in the top quartile of change in executive function (OR, 1.39), and increasing waist-to-hip ratio was linked to a significant marked decline in TBV (OR, 10.81). A significant correlation was identified between longitudinal changes in brain structure and decrease in memory and executive function.

"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," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical industry.

Abstract
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