Association of Vascular Risk Scores and Cognitive Performance in a Diverse Cohort: The Multi-Ethnic Study of Atherosclerosis

Christopher L. Schaich*, Joseph Yeboah, Mark A. Espeland, Laura D. Baker, Jingzhong Ding, Kathleen M. Hayden, Bonnie C. Sachs, Suzanne Craft, Stephen R. Rapp, Josè A. Luchsinger, Annette L. Fitzpatrick, Susan R. Heckbert, Wendy S. Post, Gregory L. Burke, Norrina B. Allen, Timothy M. Hughes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Vascular risk scores are associated with incident dementia. Information regarding their association with cognitive performance and decline in racially/ethnically diverse cohorts is lacking. Method: In 4 392 Multi-Ethnic Study of Atherosclerosis participants (aged 60.1 ± 9.4 years; 53% women; 41% White, 11% Chinese American, 26% African American, 21% Hispanic), we compared associations of Exam 1 (2000-2002) Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE), Framingham Stroke Risk Profile (FSRP), and atherosclerotic cardiovascular disease pooled cohort equation (ASCVD-PCE) risk scores with Exam 5 (2010-2012) Cognitive Abilities Screening Instrument (CASI), Digit Symbol Coding (DSC), and Digit Span (DS) cognitive test performance using multivariable linear regression, and examined racial/ethnic interactions. In 1 838 participants with repeat CASI data at Exam 6 (2016-2018), we related risk scores to odds of a 1-SD decline in CASI performance using multivariable logistic regression. Results: SD increments in each risk score were associated with worse cognitive performance. CAIDE had stronger associations with CASI performance than the FSRP and ASCVD-PCE, but associations of ASCVD-PCE with the DSC and DS were similar to CAIDE (difference in β [95% CI] = -0.57 [-1.48, 0.34] and -0.21 [-0.43, 0.01], respectively). Race/ethnicity modified associations. For example, associations between CAIDE and CASI were greater in African Americans and Hispanics than in Whites (difference in β = 0.69 [0.02, 1.36] and 1.67 [0.95, 2.39], respectively). Risk scores were comparably associated with decline in CASI performance. Conclusions: Antecedent vascular risk scores are associated with cognitive performance and decline in the 4 most common U.S. racial/ethnic groups, but associations differ among risk scores and by race/ethnicity.

Original languageEnglish (US)
Pages (from-to)1208-1215
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number6
StatePublished - Jun 1 2022


  • Cardiovascular
  • Cognition
  • Cognitive aging
  • Race/ethnicity
  • Risk factors

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Aging


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