title: Cardiovascular Risk Factors Associated with Smaller Brain Volumes in Regions Identified as Early Predictors of Cognitive Decline.
abstract: OBJECTIVE
  To determine in a large multiethnic cohort the cardiovascular and genetic risk factors associated with smaller volume in the hippocampus, precuneus, and posterior cingulate, and their association with preclinical deficits in cognitive performance in patients younger and older than 50 years.
  
  
  METHODS
  The institutional review board approved the study and all participants provided written informed consent. Eligible for this study were 1629 participants (700 men and 929 women; mean age, 50.0 years ± 10.2 [standard deviation]) drawn from the population-based Dallas Heart Study who underwent laboratory and clinical analysis in an initial baseline visit and approximately 7 years later underwent brain magnetic resonance imaging with automated volumetry and cognitive assessment with the Montreal Cognitive Assessment (MoCA). Regression analysis showed associations between risk factors and segmental volumes, and associations between these volumes with cognitive performance in participants younger and older than 50 years.
  
  
  RESULTS
  Lower hippocampal volume was associated with previous alcohol consumption (standardized estimate, -0.04; P = .039) and smoking (standardized estimate, -0.04; P = .048). Several risk factors correlated with lower total brain, posterior cingulate, and precuneus volumes. Higher total (standardized estimate, 0.06; P = .050), high-density lipoprotein (standardized estimate, 0.07; P = .003), and low-density lipoprotein (standardized estimate, 0.04; P = .037) cholesterol levels were associated with larger posterior cingulate volume, and higher triglyceride levels (standardized estimate, 0.06; P = .004) were associated with larger precuneus volume. Total MoCA score was associated with posterior cingulate volume (standardized estimate, 0.13; P = .001) in younger individuals and with hippocampal (standardized estimate, 0.06; P < .05) and precuneus (standardized estimate, 0.08; P < .023) volumes in older adults.
  
  
  CONCLUSIONS
  Smaller volumes in specific brain regions considered to be early markers of dementia risk were associated with specific cardiovascular disease risk factors and cognitive deficits in a predominantly midlife multiethnic population-based sample. Additionally, the risk factors most associated with these brain volumes differed in participants younger and older than 50 years, as did the association between brain volume and MoCA score.
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Rajiv N
authors.initials: RN
authors.lastname: Srinivasa
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Rossetti
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Mohit K
authors.initials: MK
authors.lastname: Gupta
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Roger N
authors.initials: RN
authors.lastname: Rosenberg
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Myron F
authors.initials: MF
authors.lastname: Weiner
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Peshock
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Roderick W
authors.initials: RW
authors.lastname: McColl
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Hynan
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Lucarelli
authors.affiliation: From the University of Texas Southwestern Medical Center, Department of Radiology, 5323 Harry Hines Blvd, Dallas, TX 75390.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: King
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000150:complications*; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors