Associations Between Cardiorespiratory Fitness, Cardiovascular Risk, and Cognition Are Mediated by Structural Brain Health in Midlife.
Associations Between Cardiorespiratory Fitness, Cardiovascular Risk, and Cognition Are Mediated by Structural Brain Health in Midlife.
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DOI：
10.1161/jaha.120.020688
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发表时间：
2021-09-21
影响因子：
5.4
通讯作者：
Pascual-Leone Á
中科院分区：
文献类型：
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作者：
España-Irla G;Gomes-Osman J;Cattaneo G;Albu S;Cabello-Toscano M;Solana-Sanchéz J;Redondo-Camós M;Delgado-Gallén S;Alviarez-Schulze V;Pachón-García C;Tormos JM;Bartrés-Faz D;Morris TP;Pascual-Leone Á
老年人的证据表明，较高的心肺健康和较低的心血管风险与较高的认知能力相关。然而，鉴于导致认知能力下降的大脑变化在症状出现前几十年就开始了，了解可改变的心血管因素与中年大脑健康相关的机制至关重要，并且可以帮助制定随着年龄增长而促进和维持大脑健康的策略。在 BBHI（巴塞罗那大脑健康计划）的 501 名中年（40-65 岁）成年参与者中，我们发现心肺健康、心血管风险以及认知和皮质厚度之间存在差异关联。在中年老年群体（55-65 岁）中，较高的心肺健康水平与较好的视觉空间能力和额叶负荷抽象问题解决能力显着相关（β=3.16，P=0.049）。相反，心血管风险与更好的视觉空间推理和问题解决能力（β=-0.046，P=0.002）、灵活性（β=-0.054，P<0.001）、处理速度（β=-0.115，P<0.001）和记忆力（β=-0.120，P<0.001）呈负相关。额叶区域的皮质厚度调节心肺健康和认知之间的关系，而跨越两个半球多个皮质区域的分散网络中的皮质厚度调节心血管风险和认知之间的关系。可改变的心血管因素、心肺健康、心血管风险和认知之间的关系存在于健康的中年成年人中。这些关系也由大脑结构介导，突出了潜在的机制途径，通过该途径，更高的心肺健康和更低的心血管风险可以对中年的认知功能产生积极影响。
Evidence in older adults suggests that higher cardiorespiratory fitness and lower cardiovascular risk are associated with greater cognition. However, given that changes in the brain that lead to cognitive decline begin decades before the onset of symptoms, understanding the mechanisms by which modifiable cardiovascular factors are associated with brain health in midlife is critical and can lead to the development of strategies to promote and maintain brain health as we age. In 501 middle‐aged (aged 40–65 years) adult participants of the BBHI (Barcelona Brain Health Initiative), we found differential associations among cardiorespiratory fitness, cardiovascular risk, and cognition and cortical thickness. Higher cardiorespiratory fitness was significantly associated with better visuospatial abilities and frontal loading abstract problem solving (β=3.16, P=0.049) in the older middle‐aged group (aged 55–65 years). In contrast, cardiovascular risk was negatively associated with better visuospatial reasoning and problem‐solving abilities (β=−0.046, P=0.002), flexibility (β=−0.054, P<0.001), processing speed (β=−0.115, P<0.001), and memory (β=−0.120, P<0.001). Cortical thickness in frontal regions mediated the relationship between cardiorespiratory fitness and cognition, whereas cortical thickness in a disperse network spanning multiple cortical regions across both hemispheres mediated the relationship between cardiovascular risk and cognition. The relationships between modifiable cardiovascular factors, cardiorespiratory fitness, and cardiovascular risk, and cognition are present in healthy middle‐aged adults. These relationships are also mediated by brain structure highlighting a potential mechanistic pathway through which higher cardiorespiratory fitness and lower cardiovascular risk can positively impact cognitive function in midlife.