Changes in metabolic risk factors over 10 years and their associations with late-life cognitive performance: The Multi-Ethnic Study of Atherosclerosis

BACKGROUND We examined whether changes in metabolic factors over 10 years were associated with cognitive performance. METHODS Participants from the Multi-Ethnic Study of Atherosclerosis were followed since baseline (2000-2002) with five clinical examinations. At exam 5 (2010-2012), they received a short cognitive battery (Cognitive Abilities Screening Instrument [CASI], Digit Symbol Coding [DSC], and Digit Span [DS]). We examined associations between baseline metabolic factors and their changes over time before cognitive testing. RESULTS Among 4392 participants, baseline metabolic disorders (fasting glucose, systolic and diastolic blood pressures) were significantly associated with poorer CASI, DSC, and DS scores measured 10 years later. Increases in blood pressure were associated with lower cognitive performance. Results did not differ by race/ethnicity and were stronger among those without the APOE ε4 allele. CONCLUSIONS Cognitive performance was associated with antecedent abnormalities in glucose metabolism and blood pressure increases. Findings appeared stronger among APOE ε4-negative participants.