Association between Life’s Essential 8 and cognitive function: insights from NHANES 2011–2014

Liang, Kangni; Zhang, Xiaoling

doi:10.3389/fnagi.2024.1386498

Cited by 3 publications

(1 citation statement)

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“…Three tests were used to evaluate cognitive function: the Consortium to Establish a Registry for Alzheimer’s Disease Word List (CERAD W-L) subtest, which assesses immediate and delayed recall of new verbal information ( Desai et al, 2022 ); the Animal Fluency Test (AFT), which measures categorical verbal fluency ( Zhao et al, 2013 ); and the Digit Symbol Substitution Test (DSST), which evaluates processing speed, sustained attention, and working memory ( Liu et al, 2021 ). These tests have been widely used in mass screening efforts and clinical studies ( Walsh et al, 2022 ; Liang and Zhang, 2024 ). While cognitive assessments cannot replace a clinical diagnosis based on examination, they are valuable in study cognitive function in relation to various diseases and risk factors.…”

Section: Methodsmentioning

confidence: 99%

A glimpse into the future: revealing the key factors for survival in cognitively impaired patients

Wei,

Pan,

et al. 2024

Front. Aging Neurosci.

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BackgroundDrawing on prospective data from the National Health and Nutrition Examination Survey (NHANES), our goal was to construct and validate a 5-year survival prediction model for individuals with cognitive impairment (CI).MethodsThis study entailed a prospective cohort design utilizing information from the 2011–2014 NHANES dataset, encompassing individuals aged 40 years or older, with updated mortality status as of December 31, 2019. Predictive models within the derivation and validation cohorts were assessed using logistic proportional risk regression, column-line plots, and least absolute shrinkage and selection operator (LASSO) binomial regression models.ResultsThe study enrolled a total of 1,439 participants (677 men, mean age 69.75 ± 6.71 years), with the derivation and validation cohorts consisting of 1,007 (538 men) and 432 (239 men) individuals, respectively. The 5-year mortality rate stood at 16.12% (n = 232). We devised a 5-item column-line graphical model incorporating age, race, stroke, cardiovascular disease (CVD), and blood urea nitrogen (BUN). The model exhibited an area under the curve (AUC) of 0.772 with satisfactory calibration. Internal validation demonstrated that the column-line graph model displayed strong discrimination, yielding an AUC of 0.733, and exhibited good calibration.ConclusionTo sum up, our study successfully developed and internally validated a 5-item nomogram integrating age, race, stroke, cardiovascular disease, and blood urea nitrogen. This nomogram exhibited robust predictive performance for 5-year mortality in individuals with CI, offering a valuable tool for prognostic evaluation and personalized care planning.

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Section: Methodsmentioning

confidence: 99%

A glimpse into the future: revealing the key factors for survival in cognitively impaired patients

Wei,

Pan,

et al. 2024

Front. Aging Neurosci.

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DNA Methylation Signatures of Cardiovascular Health Provide Insights into Diseases

Carbonneau,

Li,

et al. 2024

Preprint

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Background: The association of overall cardiovascular health (CVH) with changes in DNA methylation (DNAm) has not been well characterized. Methods: We calculated the American Heart Association's Life's Essential 8 (LE8) score to reflect CVH in five cohorts with diverse ancestry backgrounds. Epigenome-wide association studies (EWAS) for LE8 score were conducted, followed by bioinformatic analyses. DNAm loci significantly associated with LE8 score were used to calculate a CVH DNAm score. We examined the association of the CVH DNAm score with incident CVD, CVD-specific mortality, and all-cause mortality. Results: We identified 609 CpGs associated with LE8 score at false discovery rate (FDR) < 0.05 in the discovery analysis and at Bonferroni corrected P < 0.05 in the multi-cohort replication stage. Most had low-to-moderate heterogeneity (414 CpGs [68.0%] with I2 < 0.2) in replication analysis. Pathway enrichment analyses and phenome-wide association study (PheWAS) search associated these CpGs with inflammatory or autoimmune phenotypes. We observed enrichment for phenotypes in the EWAS catalog, with 29-fold enrichment for stroke (P = 2.4e-15) and 21-fold for ischemic heart disease (P = 7.4e-38). Two-sample Mendelian randomization (MR) analysis showed significant association between 141 CpGs and ten phenotypes (261 CpG-phenotype pairs) at FDR < 0.05. For example, hypomethylation at cg20544516 (MIR33B; SREBF1) associated with lower risk of stroke (P = 8.1e-6). In multivariable prospective analyses, the CVH DNAm score was consistently associated with clinical outcomes across participating cohorts, the reduction in risk of incident CVD, CVD mortality, and all-cause mortality per standard deviation increase in the DNAm score ranged from 19% to 32%, 28% to 40%, and 27% to 45%, respectively. Conclusions: We identified new DNAm signatures for CVH across diverse cohorts. Our analyses indicate that immune response-related pathways may be the key mechanism underpinning the association between CVH and clinical outcomes.

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Adherence to Life’s Essential 8 is associated with delayed white matter aging

Feng,

Ye,

Pan

et al. 2024

Preprint

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Importance: The American Heart Association introduced Life's Essential 8 (LE8) as a checklist of healthy lifestyle factors to help older individuals maintain and improve cardiovascular health and live longer. How LE8 can foster healthy brain aging and interact with genetic risk factors to render the aging brain less vulnerable to dementia is not well understood. Objective: To investigate the impact of LE8 on the white matter brain aging and the moderating effects of the APOE4 allele. Design, Setting, and Participants: This cross-sectional study uses genetic, imaging, and other health-related data collected in the UK Biobank cohort. Participants included non-pregnant whites with LE8 variables, diffusion tensor imaging data, and genetic data on APOE4 available, and excluded the extreme white matter hyperintensities. The baseline assessment was performed from 2006 to 2010. The diffusion tensor imaging data were collected since 2014. Exposures: LE8 variables, encompassing diet, physical activity, smoking, sleep, body mass index, lipids, hemoglobin, and blood pressure. Main Outcomes and Measures: The white matter brain age was predicted from regional fractional anisotropy measures derived from diffusion tensor imaging data using the random forest regression method. The outcome white matter brain age gap was calculated by subtracting individuals' chronological age from their predicted brain age. Results: The analysis included 9,430 women and 9,387 men (mean age 55.45 [SD: 7.46] years). Higher LE8 scores were associated with lower white matter brain age gap, indicating delayed brain aging. The findings are consistent for each of the individual LE8 variables. The effect was stronger among non-APOE4 carriers (124 days younger per 10-point increase, 95% CI, 102 to 146 days; P<0.001) than APOE4 carriers (84 days younger per 10-point increase, 95% CI, 47 to 120 days; P<0.001). Notably, early middle-aged women with APOE4 showed significant interactions between LE8 scores and brain aging (P interaction = 0.048), not observed in men. Conclusions and Relevance: Adherence to LE8 is associated with delayed brain aging, moderated by genetic factors such as APOE4. These findings highlight the potential of behavioral and lifestyle interventions in reducing dementia risk, emphasizing tailored prevention plans for those with different genetic predispositions to dementia and sex.

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Association between Life’s Essential 8 and cognitive function: insights from NHANES 2011–2014

Cited by 3 publications

References 50 publications

A glimpse into the future: revealing the key factors for survival in cognitively impaired patients

A glimpse into the future: revealing the key factors for survival in cognitively impaired patients

DNA Methylation Signatures of Cardiovascular Health Provide Insights into Diseases

Adherence to Life’s Essential 8 is associated with delayed white matter aging

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