Key correlates of incident dementia identified in the MESA study

The Multi-Ethnic Study of Atherosclerosis (MESA) deeply phenotyped dementia in a multi-ethnic cardiovascular cohort and identified key correlates of incident dementia. Among these were risk factors for cardiovascular diseases (CVD) and atherosclerosis, subclinical myocyte damage, vascular function, inflammation, physical activity, hepatic steatosis, and a history of cancer.

MESA was set up to study the correlates, predictors, and progression of subclinical CVD in a diverse population of 6,814 Americans between the ages of 45 and 84 years who had no evidence of clinical CVD at baseline. As the specific vascular contributions to dementia remain insufficiently understood, MESA set up a study to identify the correlates of incident dementia in a cardiovascular cohort. The results were presented as a poster at the ACC 2023 meeting by Dr Mohammad Ostovaneh (Johns Hopkins Hospital, MD, USA) [1].

The study included 6,806 MESA participants who had sufficient follow-up data for incident dementia. At the baseline exam, MESA collected data on almost 200 variables including demographic risk factors, past medical history, anthropometric measurements, laboratory markers, electrocardiogram, cardiac and aortic MRI, coronary artery calcium, and liver fat. From this data, correlates of incident dementia were identified using Random Survival Forest analysis, a non-parametric machine learning strategy to build a risk prediction model of survival.

Dr Ostovaneh and colleagues identified 326 cases of dementia over the course of 14 years. Beyond age, the major independent correlates of dementia included:

• coronary artery calcification;
• high-sensitivity troponin;
• common carotid artery intima-media thickness;
• N-terminal prohormone of brain natriuretic peptide (NT-proBNP);
• physical activity;
• pulse pressure;
• tumour necrosis factor-α;
• a history of cancer; and
• liver-to-spleen attenuation ratio.

The researchers added that participants over 62 years at baseline had similar dementia correlates to the cohort as a whole but, in this subgroup, IL-2 soluble receptor, apolipoprotein E, and descending aortic strain were also associated with dementia.

1. Ostovaneh M, et al. Deep phenotyping of dementia in a multi-ethnic cardiovascular cohort: The multi-ethnic study of atherosclerosis (MESA). Session 906-09, ACC Scientific Session 2023, 4–6 March, New Orleans, USA.

 

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Posted on 7 June, 202331 January, 2024