journal articles
INCREASING CARDIOVASCULAR DISEASE RISK PREDICTS FASTER COGNITIVE DECLINE: A BAYESIAN ANALYSIS OF A COHORT OF ADULTS IN RURAL WEST TEXAS
Chathurika S. Dhanasekara, Chanaka N. Kahathuduwa, Chanaka N. Kahathuduwa
BACKGROUND: Cardiovascular disease (CVD) is a major risk factor for cognitive decline and dementia. We examined whether a higher atherosclerotic cardiovascular disease (ASCVD) risk is associated with faster cognitive decline in Project FRONTIER, a rural cohort.
METHODS: Participants were aged ≥40 years without baseline CVD and completed two study visits. Primary outcomes were the RBANS Total Score and its domains; secondary outcomes were Executive Interview 25, verbal fluency, Clock Drawing Test (CLOX), and Trail Making Test (TMT) A and B. Primary exposure was the 10-year ASCVD risk per AHA PREVENT equations. We fitted Bayesian mixed-effects models to estimate the interaction between time (in years) and ASCVD risk, adjusting for covariates using brms package in R.
RESULTS: We analyzed data of 383 participants (age 57.74 ± 11.4 years; 75.5 % female; 59.8 % Hispanic; median follow-up 3.00 years, IQR: 2.67–3.64). The time×ASCVD risk interaction for RBANS Total was credibly negative (β = −1.22 points/year per 10 % higher risk, 95 % CrI −1.87 to −0.58). Strongest domain-specific effects were for attention (β = −1.25; 95 % CrI −2.14 to −0.37) and delayed memory (β = −1.36; 95 % CrI −2.16 to −0.05). CLOX suggested a credibly negative interaction (β = −0.39; 95 % CrI −0.62 to −0.16), and TMT-A showed a credibly positive interaction (β = +2.85 s/year; 95 % CrI 1.28 to 4.41).
DISCUSSION: In this rural cohort, a higher 10-year ASCVD risk was associated with faster decline in global cognition, particularly attention and delayed memory, supporting the potential value of cardiovascular risk monitoring and modification to preserve cognitive function.
CITATION:
Chathurika S. Dhanasekara ; Chanaka N. Kahathuduwa ; Volker Neugebauer (2026): Increasing cardiovascular disease risk predicts faster cognitive decline: A Bayesian analysis of a cohort of adults in rural West Texas. The Journal of Prevention of Alzheimer’s Disease (JPAD). https://doi.org/10.1016/j.tjpad.2026.100651