@article {9918, title = {Clinical and Imaging Markers of Cardiac Function and Brain Health: A Meta-Analysis of Community-Based Studies.}, journal = {Neurology}, volume = {104}, year = {2025}, month = {2025 Apr 22}, pages = {e213421}, abstract = {

BACKGROUND AND OBJECTIVES: Cardiac dysfunction and heart failure are linked to cognitive impairment, but the underlying brain pathology remains undetermined. We investigated associations between cardiac function (measured by echocardiography or cardiac MRI), clinical heart failure, and structural markers on brain MRI, including volumes of gray and white matter (WM), the hippocampus, and white matter hyperintensities (WMHs).

METHODS: We leverage data from 7 prospective, community-based cohorts across Europe and the United States, all part of the Cross-Cohort Collaboration. The included cohorts were the Age, Gene/Environment Susceptibility-Reykjavik Study, Atherosclerosis Risk in Communities study, Austrian Stroke Prevention Study, Cardiovascular Health Study, Framingham Heart Study, Rotterdam Study, and Study of Health in Pomerania (SHIP-START and SHIP-TREND). Each cohort performed cross-sectional multivariable linear regression analyses, after which estimates were pooled through random-effects meta-analysis. Heterogeneity was assessed by the index (\%).

RESULTS: Among 10,889 participants (mean age: 66.8 years, range 52.0-76.0; 56.7\% women), markers of systolic dysfunction were consistently associated with smaller total brain volume (TBV) (e.g., adjusted standardized mean difference for moderate to severe dysfunction -0.19, 95\% CI -0.31 to -0.07, = 20\%). Impaired relaxation and restrictive diastolic dysfunction were also associated with smaller TBV (e.g., for impaired relaxation -0.08, 95\% CI -0.15 to -0.01, = 32\%) and hippocampal volume (-0.18, 95\% CI -0.33 to -0.03, = 0\%), with similar results for the E/A-ratio. Systolic and diastolic dysfunction was not consistently associated with volume of WMHs. Among 5 cohorts with available data, 302 (3.4\%) participants had clinical heart failure, which was associated with smaller brain volumes, particularly in the hippocampus (-0.13, 95\% CI -0.23 to -0.02, = 1\%).

DISCUSSION: In this large study among community-dwelling adults, subclinical cardiac dysfunction was associated with brain imaging markers of neurodegeneration. These findings encourage longitudinal investigations on the effect of maintaining cardiac function on brain health.

}, keywords = {Aged, Brain, Cohort Studies, Echocardiography, Female, Heart Failure, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, White Matter}, issn = {1526-632X}, doi = {10.1212/WNL.0000000000213421}, author = {Yaqub, Amber and Bis, Joshua C and Frenzel, Stefan and Koini, Marisa and Mbangdadji, Djass and Peloso, Gina M and Talluri, Rajesh and Alonso, Alvaro and Bahls, Martin and B{\"u}low, Robin and D{\"o}rr, Marcus and Felix, Stephan and Fohner, Alison and Friedrich, Nele and Hofer, Edith and Kavousi, Maryam and Launer, Lenore J and Le, Tran and Longstreth, Will and Mosley, Thomas H and Vernooij, Meike W and V{\"o}lzke, Henry and Wittfeld, Katharina and Beiser, Alexa S and Grabe, Hans J and Gudnason, Vilmundur and Ikram, Mohammad Arfan and Psaty, Bruce M and Schmidt, Reinhold and Simino, Jeannette and Seshadri, Sudha and Wolters, Frank J} } @article {9940, title = {Selected social and lifestyle correlates of brain health markers: the Cross-Cohort Collaboration Consortium.}, journal = {Alzheimers Dement}, volume = {21}, year = {2025}, month = {2025 Apr}, pages = {e70148}, abstract = {

INTRODUCTION: To investigate the associations of education level, marital status, and physical activity with dementia risk and brain MRI markers.

METHODS: Data from six community-based samples from the Cross-Cohort Collaboration Consortium were analyzed. Self-reported education level, marital status, and physical activity at age 60 to 75 years were harmonized. Subsamples of participants with brain MRI markers at time of exposure were selected. Associations with dementia risk and cross-sectional MRI markers were meta-analyzed.

RESULTS: Higher education level was associated with lower dementia risk (hazard ratio [HR]~=~0.65, 95\% confidence interval [CI]~=~0.59; 0.72~vs low level) but not significantly with brain MRI markers. Compared with being unmarried, being married was only associated with higher total brain and hippocampal volumes. Being physically active was associated with lower dementia risk (HR~=~0.73, 95\% CI~=~0.52; 1.04), as well as larger total brain volume and smaller white matter hyperintensity volume.

DISCUSSION: This study provides further evidence regarding the contribution of education level and physical activity to dementia resilience.

HIGHLIGHTS: Education level, marital status, and physical activity are thought to contribute to resilience against ADRD. We used random-effects meta-analysis to summarize results from six community-based samples from the CCC. In this cross-cohort meta-analysis, higher education level and being physically active were associated with lower risk of dementia. In cross-sectional analyses, being married was associated with larger TBV and HV, while being physically active was associated with larger TBV and lower WMHV.

}, keywords = {Aged, Brain, Cohort Studies, Cross-Sectional Studies, Dementia, Educational Status, Exercise, Female, Humans, Life Style, Magnetic Resonance Imaging, Male, Marital Status, Middle Aged, Risk Factors}, issn = {1552-5279}, doi = {10.1002/alz.70148}, author = {Grasset, Leslie and Bis, Joshua C and Frenzel, Stefan and Kojis, Daniel and Simino, Jeannette and Yaqub, Amber and Beiser, Alexa and Berr, Claudine and Bressler, Jan and B{\"u}low, Robin and DeCarli, Charles S and Fohner, Alison E and Harrington, Laura B and Helmer, Catherine and Ikram, M Arfan and Lemaitre, Rozenn N and Lopez, Oscar L and Longstreth, W T and Neitzel, Julia and Odden, Michelle C and Palta, Priya and Schmidt, Carsten O and Talluri, Rajesh and Vernooij, Meike W and V{\"o}lzke, Henry and Voortman, Trudy and Whalen, Quest and Wittfeld, Katharina and Grabe, Hans J and Mosley, Thomas H and Psaty, Bruce M and Wolters, Frank J and Seshadri, Sudha and Dufouil, Carole} }