JMIR Publications

ABSTRACT

Background:

Adults with cardiovascular disease risk factors (CVRFs) are also at increased risk of developing cognitive decline and dementia. However, it is often difficult to study relationships between CVRFs and cognitive function because cognitive assessment typically requires time-consuming in-person neuropsychological evaluations that may not be feasible for real-world situations.

Objective:

We conducted a proof-of-concept study to determine if association between CVRFs and cognitive function could be detected using web-based, self-administered cognitive tasks and CVRF assessment.

Methods:

We recruited 239 participants age ≥50 (mean age 62.7 ± 8.8, 42.7% female, 88.7% white) who were enrolled in the Health eHeart study, a web-based platform focused on cardiac disease. Participants self-reported CVRFs (hypertension, high cholesterol, diabetes, and atrial fibrillation) using web-based health surveys between August, 2016 and July, 2018. After an average of three years of follow-up, we remotely evaluated episodic memory, working memory, and executive function via the web-based Posit Science platform, BrainHQ. Raw data was normalized and averaged into three domain scores. We used linear regression models to examine the association between CVRFs and cognitive function.

Results:

CVRF prevalence was 62.8% for high cholesterol, 45.2% for hypertension, 10.9% for atrial fibrillation, and 7.5% for diabetes. In multivariable models atrial fibrillation was associated with worse working memory (β = -0.51, 95%CI -0.91,-0.11) and worse episodic memory (β = -0.31, 95%CI -0.59,-0.04); hypertension was associated with worse episodic memory (β = -0.27, 95%CI -0.44, -0.11). Diabetes and high cholesterol were not associated with cognitive performance.

Conclusions:

Self-administered, web-based tools can be used to detect both CVRFs and cognitive health. We observed that atrial fibrillation and hypertension were associated with worse cognitive function even in those in their 6th and 7th decade. The potential of mobile assessments to detect risk factors for cognitive aging merits further investigation.