Cardiovascular Health Maintained Over Time Linked to Reduced Risk of Neurodegenerative Disease, Study Suggests
Higher levels of cardiovascular health were associated with lower levels of neurofilament light chain across age, sex, race/ethnicity, and Alzheimer disease risk.
A recent cohort study conducted within the Chicago Health and Aging Project (CHAP) has revealed a significant association between cardiovascular health (CVH) and biomarkers of neurodegeneration in older adults. The study, led by investigators from the Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, II, found that participants with higher CVH scores had notably lower serum levels of neurofilament light chain (NfL), a biomarker of neuronal deterioration, and that levels increased more slowly over time.
This association was particularly pronounced among Black adults, who are known to experience a higher prevalence of cardiovascular disease (CVD). The findings were published online March 12, in JAMA Network Open.1
Life's Simple 7 - American Heart Association
The study cohort of adults aged 65 years and older (mean age 73.1 years) numbered 1018 of which 61.4% were women and approximately 60% were Black individuals.1 Researchers divided the group into 3 subgroups based on CVH scores as defined by the American Heart Association Life’s Simple 7 tool: 0-6 points (low CVH), 7-9 points (moderate CVH), and 10-14 points (high CVH).2
First author Anisa Dhana, MD, MSc, a postdoctoral research fellow for the Rush Institute for Healthy Aging, and colleagues reported that higher CVH scores (10-14 points) were associated with a 18.9% relative decrease in serum level of NfL compared with low CVH scores (β = −0.091; SE, 0.025; P <.001). A higher CVH score was also linked to a 1.7% slower annual increase in NfL levels as study participants aged (β = −0.008; SE, 0.004). After multivariable adjustment, the team found that a 1-point increase in CVH score was associated with a statistically significant 3.5% relative decrease in serum NfL levels (β = −0.015; SE, 0.004; P <.001). They observed no association between CVH and serum levels of total tau (t-tau), another biomarker of neurodegeneration and a co-primary outcome measure.1
In their analysis of the association of CVH score and serum biomarker concentrations by sex and race/ethnicity, multivariable adjusted models demonstrated that a 1-point increase in CVH score was associated with lower serum levels of NfL in both men and women and also among both Black and White individuals (see Figure).1 Among APOE e4 carriers the investigators found a statistically significant association between increasing CVH scores and decreasing NfL serum levels (β = −0.022; SE, 0.007; P =.002) but the association did not hold among noncarriers (β = −0.010; SE, 0.005; P =.052).1
The American Heart Association's Life’s Simple 7 tool, designed to promote cardiovascular CVH, has been linked to a reduced risk of CVD and stroke.2 The tool is gaining attention for its potential impact beyond heart disease with research now exploring its connection to cognitive health and neurodegenerative diseases. Previous studies3,4 have shown that optimal CVH is associated with a slower rate of cognitive decline, a lower risk of Alzheimer’s disease, and reduced white matter hyperintensity volumes. “Since cardiovascular disease and dementia share common risk factors, we aimed to investigate the role of Life’s Simple 7 in the neurodegeneration process,” wrote authors.1
Dhana et al examined the relationship between CVH and neurodegenerative biomarkers over a 10-year follow-up period, with a particular focus on differences between Black and White individuals.
To the latter end, the researchers tapped the CHAP, a longitudinal, biracial, population-based study that enrolled more than 10,000 adults aged 65 years and older from the South Side of Chicago, with data collected every 3 years between 1993 and 2012. Participants who had measured serum NfL and t-tau levels and data on all components of the CVH score were included.1
Among several limitations to their study that should encourage caution in interpretation of the results the authors point to use of self-reported data on CVH, the absence of further CVH assessment after the baseline visit, the restricted age of the cohort, and the variability inherent in the serum biomarkers themselves as well as their collection.1
The cautions notwithstanding, Dhana and fellow researchers state that their findings underscore the importance of managing vascular risk factors through a healthy lifestyle over time, which could potentially reduce the risk of neurodegeneration. “The association between CVH and NfL levels was consistent across different demographics, including sex, race, and APOE e4 carrier status. However, no significant association was found between CVH and t-tau levels, indicating that different biomarkers may be influenced by distinct pathways,” they concluded.1
