Abdominal aortic calcification and cognitive function among older adults: Cross-sectional analysis of National Health and Nutrition Examination Survey, 2013-2014

Objectives Subclinical atherosclerotic disease is an emerging risk factor for cognitive function among older adults, though less is known about the association between abdominal aortic calcification (AAC) and cognitive function. This study aimed to examine the cross-sectional association of AAC with cognitive function in a nationally representative sample of population in the U.S. Methods A total of 1,209 older adults (60 years or older) in the 2013-2014 National Health and Nutrition Examination Survey were included. AAC was obtained with dual-energy X-ray absorptiometry. Cognitive function was examined using the CERAD Word Learning subtest (memory), Digit Symbol Substitution Test (executive function/processing speed), and Animal Fluency Test (language). Test-specific and global cognition z-scores were created based on means and standard deviations of cognitive tests. Multivariable linear regression models were used to examine the associations of presence of AAC and severity of AAC with cognition z-scores. Results Adjusted for covariates, presence of AAC was associated with poorer global cognition (beta (beta) = -0.17, 95% confidence interval (CI): -0.28, -0.06), memory (beta = -0.20, 95% CI: -0.31, -0.09), and language ability (beta = -0.15, 95% CI: -0.29, -0.01). More severe AAC was associated with poorer cognitive function. The associations were significant among participants <75 years. Discussion The presence of AAC and greater severity of AAC, were associated with poorer cognitive function, particularly among older adults <75 years. Future research is expected to assess whether lowering global vascular risk can slow cognitive decline.