Relationship of Indicators of Cardiovascular Health With Change in Cognition in Older Blacks

Older Blacks perform more poorly on cognitive testing than older Whites. Increased prevalence of cardiovascular disease risk factors (CVD-RFs) among Blacks compared to Whites contribute to these disparities. We investigated whether white matter hyperintensities (WMHs) in late-life, a consequence of mid-life CVD-RFs, modify the association between late-life CVD-RFs and cognition in 167 Blacks (age~75yrs; non-demented at baseline). Participants were evaluated for blood pressure (BP) markers of cardiovascular health (systolic/diastolic BP, pulse pressure, mean arterial pressure (MAP) hypertension), WMH volumes adjusted for intracranial volume, and cognition (global and domain-specific at baseline and annually, ~8yrs). Adjusted models revealed differential associations between BP markers and baseline cognition; diastolic BP and MAP predicted faster decline in episodic memory. Hypertension was not significant in any model; however, when adding WMH, the hypertension*WMH interaction was significant for baseline cognition. Cognition among older Blacks is a complex function of BP markers of cardiovascular health and WMH.