Coronary artery calcium score may predict aging trajectory for older adults
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Key takeaways:
- Older adults with a coronary artery calcium score of 0 had more favorable aging indices.
- The data suggest a link between subclinical atherosclerosis and unhealthy aging.
Older adults with a coronary artery calcium score of 0 had more favorable aging indices, including normal cognitive function, vascular function and better hearing, compared with those with CAC scores of 1,000 or greater, data show.
In an analysis of adults aged 75 years and older who participated in the ARIC cohort study, researchers also found that participants with a CAC score of 0 had the lowest mean composite aging score, whereas those with a CAC score of 1,000 or greater had a significantly higher mean composite aging score.
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“While age is typically noted as a major risk factor for cognitive decline in the elderly, our findings of normal cognitive function associated with the absence of CAC among older adults highlights that healthy brain aging and cognition may share similar risk factors with heart health, supporting the heart-brain hypothesis of shared risk factors,” Michael J. Blaha, MD, MPH, professor of medicine and director of clinical research at the Ciccarone Center for the Prevention of Cardiovascular Disease at Johns Hopkins Medicine, and colleagues wrote in Atherosclerosis. “This is further emphasized by our findings of very elevated CAC being associated with dementia, consistent with a few prior studies that have associated CAC with cognitive decline, independent of age, education, sex and other risk factors.”
Blaha and colleagues analyzed data from 2,290 ARIC participants who were free of known CVD and underwent CAC scoring at study visit 7 (2018-2019) as part of the ARIC CAC ancillary study. The mean age of participants was 81 years; 38.6% were men and 77.7% were white. Researchers examined the cross-sectional association of a CAC score of 0; a CAC score between 1 and 999 (reference); and a CAC score of 1,000 or greater with seven domains of aging: cognitive function, hearing, ankle-brachial index (ABI), pulse-wave velocity (PWV), forced vital capacity (FVC), physical functioning and grip strength.
Within the cohort, 10.3% had a CAC score of 0 and 19.2% had a CAC score of 1,000 or greater.
Participants with a CAC score of 0 vs. 1,000 or greater had the lowest proportion of dementia (2.1% vs. 8%); hearing impairment (45.6% vs. 67.3%); low ABI (2.5% vs. 17.5%); high PWV (26.6% vs. 40.9%); reduced FVC (33.7% vs. 41.8%); impaired grip strength (65.8% vs. 74.3%); and mean composite abnormal aging score (2.62 vs. 3.71). There were no between-group differences in physical function.
Additionally, those with a CAC score of 0 were less likely to have abnormal ABI (adjusted OR = 0.15; 95% CI, 0.07-0.34); high PWV (aOR = 0.57; 95% CI, 0.41-0.8); and reduced FVC (aOR = 0.69; 95% CI, 0.5-0.96). Participants with CAC score of 1,000 or greater were more likely to have low ABI (aOR = 1.74; 95% CI, 1.27-2.39); high PWV (aOR = 1.52; 95% CI, 1.15-2); impaired physical functioning (aOR = 1.35; 95% CI, 1.05-1.73); and impaired grip strength (aOR = 1.46; 95% CI, 1.08-1.99).
“While CAC scores of 0 do not imply a complete absence of some of the decline seen with older age, as evidenced by the average composite aging score of 2.6 among individuals in that group, there was, however, a strong association between increasing CAC and the composite aging score, further reinforcing an association between subclinical atherosclerosis and overall healthy/unhealthy aging,” the researchers wrote.
The researchers noted that the findings suggest that vascular aging, as identified by CT imaging, can be utilized as a marker for aging phenotypes and aging trajectory, potentially guiding treatment strategies for older adults.
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