Revised Framingham Stroke Risk Profile: Association with Cognitive Status and MRI-Derived Volumetric Measures.
BACKGROUND
The Framingham Stroke Risk Profile (FSRP) was created in 1991 to estimate 10-year risk of stroke. It was revised in 2017 (rFSRP) to reflect the modern data on vascular risk factors and stroke risk.


OBJECTIVE
This study examined the association between the rFSRP and cognitive and brain aging outcomes among participants from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS).


METHODS
Cross-sectional rFSRP was computed at baseline for 19,309 participants (mean age = 72.84, SD = 8.48) from the NACC-UDS [9,697 (50.2%) normal cognition, 4,705 (24.4%) MCI, 4,907 (25.4%) dementia]. Multivariable linear, logistic, or ordinal regressions examined the association between the rFSRP and diagnostic status, neuropsychological test performance, CDR® Sum of Boxes, as well as total brain volume (TBV), hippocampal volume (HCV), and log-transformed white matter hyperintensities (WMH) for an MRI subset (n = 1,196). Models controlled for age, sex, education, racial identity, APOEɛ4 status, and estimated intracranial volume for MRI models.


RESULTS
The mean rFSRP probability was 10.42% (min = 0.50%, max = 95.71%). Higher rFSRP scores corresponded to greater CDR Sum of Boxes (β= 0.02, p = 0.028) and worse performance on: Trail Making Test A (β= 0.05, p < 0.001) and B (β= 0.057, p < 0.001), and Digit Symbol (β= -0.058, p < 0.001). Higher rFSRP scores were associated with increased odds for a greater volume of log-transformed WMH (OR = 1.02 per quartile, p = 0.015). No associations were observed for diagnosis, episodic memory or language test scores, HCV, or TBV.


CONCLUSION
These results support the rFSRP as a useful metric to facilitate clinical research on the associations between cerebrovascular disease and cognitive and brain aging.
['Pelcher|Isabelle|I|', 'Puzo|Christian|C|', 'Tripodis|Yorghos|Y|', 'Aparicio|Hugo J|HJ|', 'Steinberg|Eric G|EG|', 'Phelps|Alyssa|A|', 'Martin|Brett|B|', 'Palmisano|Joseph N|JN|', 'Vassey|Elizabeth|E|', 'Lindbergh|Cutter|C|', 'McKee|Ann C|AC|', 'Stein|Thor D|TD|', 'Killiany|Ronald J|RJ|', 'Au|Rhoda|R|', 'Kowall|Neil W|NW|', 'Stern|Robert A|RA|', 'Mez|Jesse|J|', 'Alosco|Michael L|ML|']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D000959:Antihypertensive Agents D001281:Atrial Fibrillation D001794:Blood Pressure D001921:Brain D002318:Cardiovascular Diseases D003071:Cognition D060825:Cognitive Dysfunction D003920:Diabetes Mellitus D005260:Female D006624:Hippocampus D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D009483:Neuropsychological Tests D009929:Organ Size D012307:Risk Factors D012737:Sex Factors D012907:Smoking D020521:Stroke
framingham stroke risk profile stroke risk cerebrovascular disease Alzheimer’s disease cardiovascular disease