Atherosclerotic cardiovascular disease risk is associated with AT(N)V neuroimaging biomarkers and cognitive impairment in the health and aging brain study-health disparities cohort.
5 affiliations
- 1Department of Neurosciences, Alzheimer's Disease Cooperative Study (ADCS), University of California San Diego, San Diego, CA, United States.
- 2Department of Biological Sciences, University of California San Diego, San Diego, CA, United States.
- 3Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, United States.
- 4Sanders-Brown Center on Aging, College of Medicine, University of Kentucky, Lexington, KY, United States.
- 5Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, KY, United States.
Abstract
Background
Cardiovascular risk is increasingly recognized as relevant to cognitive aging and dementia-related brain changes, yet its relationship to multimodal neuroimaging biomarkers of amyloid, tau, neurodegeneration, and vascular injury (AT(N)-V) remains incompletely understood in racially and ethnically diverse cohorts. We examined whether ten-year atherosclerotic cardiovascular disease (ASCVD) risk was associated with AT(N)-V neuroimaging biomarkers and cognitive domain scores.Methods
This cross-sectional study included 1,626 Health and Aging Brain Study-Health Disparities (HABS-HD) participants without cardiovascular disease or dementia who had amyloid positron emission tomography (PET) imaging linked to visit 1. Ten-year ASCVD risk was estimated using the Pooled Cohort Equations and modeled continuously. Neuroimaging outcomes included global florbetaben amyloid PET standardized uptake value ratio (SUVR), medial temporal lobe (MTL) PI-2620 tau PET SUVR, cortical thickness, hippocampal volume, and white matter hyperintensity (WMH) volume. Cognitive domain outcomes included memory, executive function, processing speed, and language. Multivariable linear regression models accounted for apolipoprotein E (APOE) ε4 status, relevant neuroimaging biomarkers, and imaging scanner/protocol covariates as appropriate, with Holm adjustment for multiple comparisons. Amyloid-status-stratified analyses were also conducted using a global amyloid PET SUVR threshold of 1.08.Results
Increasing ten-year ASCVD risk was associated with increasing global amyloid and MTL tau PET SUVR, smaller cortical thickness, smaller hippocampal volume, and increased WMH volume. Increasing ten-year ASCVD risk was also associated with lower memory, executive function, processing speed, and language scores after accounting for APOE ε4 status, amyloid burden, neurodegeneration, vascular injury, and scanner covariates. Associations between ten-year ASCVD risk and structural and vascular injury markers were observed in both amyloid-positive and amyloid-negative participants, whereas associations with amyloid and MTL tau PET were modest and statistically significant only among amyloid-negative participants.Conclusion
In this diverse HABS-HD sample, increasing ten-year ASCVD risk was associated with greater AT(N)-V biomarker burden and poorer cognitive performance across multiple domains. These cross-sectional findings suggest that ten-year ASCVD risk may serve as a marker of co-occurring cardiovascular and brain health burden, but they do not establish causality or temporal direction.
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BibTeX
@article{espejo2026atherosclerotic,
title = {{Atherosclerotic cardiovascular disease risk is associated with AT(N)V neuroimaging biomarkers and cognitive impairment in the health and aging brain study-health disparities cohort.}},
author = {Kimberly Espejo and Ryan Rulkens and Cellas A Hayes and Joey A Contreras},
journal = {Frontiers in aging neuroscience},
year = {2026},
month = oct,
doi = {10.3389/fnagi.2026.1874472},
url = {https://europepmc.org/article/MED/42898366},
note = {CC BY},
}
RIS
TY - JOUR
TI - Atherosclerotic cardiovascular disease risk is associated with AT(N)V neuroimaging biomarkers and cognitive impairment in the health and aging brain study-health disparities cohort.
AU - Kimberly Espejo
AU - Ryan Rulkens
AU - Cellas A Hayes
AU - Joey A Contreras
PY - 2026
DA - 2026/10/05
JO - Frontiers in aging neuroscience
DO - 10.3389/fnagi.2026.1874472
UR - https://europepmc.org/article/MED/42898366
AB - Background Cardiovascular risk is increasingly recognized as relevant to cognitive aging and dementia-related brain changes, yet its relationship to multimodal neuroimaging biomarkers of amyloid, tau, neurodegeneration, and vascular injury (AT(N)-V) remains incompletely understood in racially and ethnically diverse cohorts. We examined whether ten-year atherosclerotic cardiovascular disease (ASCVD) risk was associated with AT(N)-V neuroimaging biomarkers and cognitive domain scores.Methods This cross-sectional study included 1,626 Health and Aging Brain Study-Health Disparities (HABS-HD) participants without cardiovascular disease or dementia who had amyloid positron emission tomography (PET) imaging linked to visit 1. Ten-year ASCVD risk was estimated using the Pooled Cohort Equations and modeled continuously. Neuroimaging outcomes included global florbetaben amyloid PET standardized uptake value ratio (SUVR), medial temporal lobe (MTL) PI-2620 tau PET SUVR, cortical thickness, hippocampal volume, and white matter hyperintensity (WMH) volume. Cognitive domain outcomes included memory, executive function, processing speed, and language. Multivariable linear regression models accounted for apolipoprotein E (APOE) ε4 status, relevant neuroimaging biomarkers, and imaging scanner/protocol covariates as appropriate, with Holm adjustment for multiple comparisons. Amyloid-status-stratified analyses were also conducted using a global amyloid PET SUVR threshold of 1.08.Results Increasing ten-year ASCVD risk was associated with increasing global amyloid and MTL tau PET SUVR, smaller cortical thickness, smaller hippocampal volume, and increased WMH volume. Increasing ten-year ASCVD risk was also associated with lower memory, executive function, processing speed, and language scores after accounting for APOE ε4 status, amyloid burden, neurodegeneration, vascular injury, and scanner covariates. Associations between ten-year ASCVD risk and structural and vascular injury markers were observed in both amyloid-positive and amyloid-negative participants, whereas associations with amyloid and MTL tau PET were modest and statistically significant only among amyloid-negative participants.Conclusion In this diverse HABS-HD sample, increasing ten-year ASCVD risk was associated with greater AT(N)-V biomarker burden and poorer cognitive performance across multiple domains. These cross-sectional findings suggest that ten-year ASCVD risk may serve as a marker of co-occurring cardiovascular and brain health burden, but they do not establish causality or temporal direction.
SN - 1663-4365
ER -