Cognitive function and cardiovascular health in the elderly: network analysis based on hypertension, diabetes, cerebrovascular disease, and coronary heart disease

Abstract

IntroductionCognitive decline in the elderly population is a growing concern, and vascular factors, such as hypertension, diabetes, cerebrovascular disease, and coronary heart disease, have been associated with cognitive impairments. This study aims to provide deeper insights into the structure of cognitive function networks under these different vascular factors and explore their potential associations with specific cognitive domains.MethodsCognitive function was assessed using a modified Chinese version of the mini-mental state examination (MMSE) scale, and intensity centrality and side weights were estimated by network modeling. The network structure of cognitive function was compared across subgroups by including vascular factors as subgroup variables while controlling for comorbidities and confounders.ResultsThe results revealed that cerebrovascular disease and coronary heart disease had a more significant impact on cognitive function. Cerebrovascular disease was associated with weaker centrality in memory and spatial orientation, and a sparser cognitive network structure. Coronary heart disease was associated with weaker centrality in memory, repetition, executive function, recall, attention, and calculation, as well as a sparser cognitive network structure. The NCT analyses further highlighted significant differences between the cerebrovascular disease and coronary heart disease groups compared to controls in terms of overall network structure and connection strength.ConclusionOur findings suggest that specific cognitive domains may be more vulnerable to impairments in patients with cerebrovascular disease and coronary heart disease. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations, inform personalized cognitive intervention strategies, and provide a better understanding of the potential mechanisms underlying cognitive decline in patients with vascular diseases.

Association of peripheral B cells and delirium: combined single-cell sequencing and Mendelian randomization analysis

“…Delirium, on the other hand, often occurs within a short period of time after an intense inflammatory stress event in vulnerable populations, such as delirium occurring for a short period in elderly surgical patients (6,7). Notably, neurological and cognitive impairments are also frequently observed in chronic diseases such as inflammatory bowel disease, chronic obstructive pulmonary disease, silicosis, coronary heart disease, diabetes mellitus, and nonalcoholic fatty liver disease (8)(9)(10)(11)(12), and these populations are at a significantly higher risk of delirium after experiencing intense inflammatory stress (13)(14)(15). This phenomenon suggests a possible association of peripheral systems with central neurophysiologic interactions, and suggests that immune and inflammatory alterations in the periphery may induce neurocognitive impairment.…”