Association of the LIfestyle for BRAin Health Score and Brain Vascular Damage in a Community-Dwelling Adults Cohort

OBJECTIVETo investigate the association of brain vascular damage and the LIfestyle for BRAin Health (LIBRA) dementia risk scores. METHODSThis cross-sectional study was based on the baseline survey from a population-based prospective cohort study. The Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE) study recruited community-dwelling adults aged 50-75 years based on cluster sampling from Lishui city in China. Eleven modifiable risk or protective factors for dementia collected at baseline survey were combined in the LIBRA score. Eligible participants were scanned by a 3.0T Magnetic resonance imaging scanner. Intracranial atherosclerosis and cerebral small vessel disease (CSVD) burden were assessed. RESULTSIn a total of 3059 individuals, the mean (SD) age was 61.2 (6.7) years; 1630 (53.5%) being women. Compared with the first tertile, subjects with the third tertile of LIBRA score were associated with increased odds of the presence of intracranial atherosclerotic plaque (adj. OR 2.22, 95% CI 1.75 to 2.82, P <0.001). A similar association was observed for intracranial atherosclerotic burden (adj. cOR 2.26, 95% CI 1.79 to 2.87, P <0.001). Whereas, subjects with the third tertile of LIBRA score were not associated with the presence of CSVD (adj. OR 1.05, 95% CI 0.86 to 1.29, P =0.63) or higher CSVD burden (adj. cOR 1.06, 95% CI 0.87 to 1.29, P =0.55). Multivariable binary logistic regression analysis for the association between the LIBRA score and the presence of coexistent atherosclerotic plaque and CSVD was also significant adjusting for the nonmodifiable factors age, sex, education, married or cohabiting status, socioeconomic status, and history of stroke (adj. OR 1.70, 95% CI 1.21 to 2.39, P = 0.002). CONCLUSIONSIn this study, LIBRA scores were positively associated with the presence and burden of intracranial atherosclerosis, coexistence of atherosclerotic plaque and CSVD. These findings suggested that modifiable dementia score maybe useful in identifying individuals at high risk of brain vascular damage.