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Research Article: Relationship between Framingham Cardiovascular Risk Score and cognitive performance among ageing rural Indian participants: a cross-sectional analysis

Date Published: 2023-11-10

Abstract:
Objective The burden of cardiovascular risk factors is increasing in India, which, in turn, can adversely impact cognition. Our objective was to examine the effect of cardiovascular risk factors measured by Framingham Risk Score (FRS) on cognitive performance among a cohort of healthy, ageing individuals (n=3609) aged ?45 years from rural India. Design A cross-sectional analysis. Setting A rural community setting in southern India. Participants Healthy, ageing, dementia-free participants, aged 45 years and above, belonging to the villages of Srinivaspura (a rural community located around 100 km from Bangalore, India), were recruited. Primary outcome measures Using a locally adapted, validated, computerised cognitive test battery, we assessed cognitive performance across multiple cognitive domains: attention, memory, language, executive functioning and visuospatial ability. Results The median (IQR) age of the sample was 57 (50.65) and 50.5% were women. Multiple linear regression analysis showed that participants with higher FRS performed poorly in attention (visual attention (?=?0.018, p=0.041)), executive functioning (categorical fluency (?=?0.064, p<0.001)), visuospatial ability (form matching (?=?0.064, p<0.001) and visuospatial span (?=?0.020, p<0.001)), language (reading and sentence comprehension (?=?0.010, p=0.013), word comprehension (?=?0.021, p<0.001) and semantic association (?=?0.025, p<0.001)), and memory (episodic memory IR (?=?0.056, p<0.001), episodic memory DR (?=?0.076, p<0.001) and name-face association (?=?0.047, p<0.001)). Conclusion Increased cardiovascular risk as evidenced by FRS was associated with poorer cognitive performance in all cognitive domains among dementia-free middle-aged and older rural Indians. It is imperative to design and implement appropriate interventions (pharmacological and lifestyle-based) for cardiovascular risk reduction and thereby, prevent or mitigate accelerated cognitive impairment in ageing individuals.

Introduction:
Dementia is a complex condition that affects the brain and is characterised by a progressive decline in cognitive function, which can seriously impair an individual’s ability to perform activities of daily living. This can have a significant impact on the individual’s quality of life, as well as on their family and caregivers. The changes in demographic patterns in India are contributing to a rapid rise in the prevalence of dementia. 1 The number of people living with dementia in India by 2050 is projected to be…

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