A-140: Associations Between Cardiovascular Risk Burden and Executive Function in Older Adults: A Longitudinal Study

Abstract

Objective: To determine whether greater cardiovascular risk burden (CRB) is associated with poorer baseline executive function (EF) and accelerated longitudinal decline in older adults. Method/Data Selection: Data were drawn from 435 older adults (2,568 observations; 52.4% male; mean education = 16.03 years; normal to mildly impaired cognition) enrolled at the Memory and Aging Center and the UC Davis Alzheimer’s Disease Research Center. CRB was defined as the number of conditions present (hypertension, diabetes, hypercholesterolemia, sleep apnea, coronary artery disease, stroke, congestive heart failure, and atrial fibrillation), with primary analyses restricted to participants with ≥6 conditions. EF was measured using a composite score derived from modified trail-making, design fluency, lexical fluency, color-word interference, and backward number span tasks. Regression and linear mixed-effects models evaluated baseline performance and longitudinal change, adjusting for age, sex, and education. Results/Data Synthesis: EF declined over time (95% confidence interval [CI] [−0.04, −0.01], p = .008). CRB was not associated with baseline or longitudinal EF or rate of decline, and findings were unchanged in longitudinal sensitivity analyses (all ps ≥ .095). However, in cross-sectional sensitivity analyses, greater CRB was significantly associated with poorer EF (95% CI [−0.11, −0.06], p < .001). Conclusions: CRB may have limited utility as a standalone marker of EF in healthier older adults. A significant association observed only in cross-sectional sensitivity analysis suggests that findings may depend on how cardiovascular risk is operationalized and are not stable over time. Future work examining alternative approaches to measuring cardiovascular burden, longer follow-up periods, and more diverse or higher-risk populations would better characterize these relationships.