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Can CV Fat Predict Cognitive Function in Women in Midlife?

— Quality of fat, not quantity, was tied to working memory, researchers say

MedpageToday

The quality of cardiovascular (CV) fat in midlife women may predict their cognitive function later on in life, a researcher found.

High radiodensity of perivascular adipose tissue (PVAT) around the descending aorta among women in their middle years (average age around 51) was significantly associated with worse working memory in the future (P=0.01), reported Meiyuzhen Qi, MPH, of the University of Pittsburgh (Pitt).

Each unit increase of PVAT was associated with a 0.29 unit decrease in working memory, Qi said in a presentation at the North American Menopause Society (NAMS) virtual meeting.

While Qi and colleagues group found that the quality of fat around the blood vessels was significantly associated with cognitive function later in life, fat volume was not significant. The quantity and quality of lower epicardial and total heart fat tissue were not related to memory.

"The fat around the descending aorta had a relationship with working memory for our participants," said co-author Samar El Khoudary, PhD, MPH, also of Pitt.

"What is novel here is that we found the quality of the fat around the vessels, rather than the quantity, could be a marker of cognitive decline in midlife women," she told ֱ.

Higher radiodensity of fat around the blood vessels may indicate an increase in inflammatory markers to the brain, El Khoudary stated. While this could be a potential mechanism of cognitive decline, she emphasized that future research should look further into pathophysiology.

In this study, Qi's group used data from the (SWAN) to assess the volume and radiodensity of CV fat among midlife women, as well as the relation to cognitive function.

Researchers collected data on the volume and radiodensity of lower epicardial adipose tissue, total heart adipose tissue, and PVAT surrounding the descending aorta, which were measured by a CT scan at one visit during the course of the SWAN study. Working memory, verbal episodic memory immediate and delayed recall, and processing speed were measured repeatedly throughout the study starting at the fourth visit.

Researchers adjusted for education level, race, age, menopausal status, HDL cholesterol, waist circumference, systolic blood pressure, as well as other confounding factors.

There were 487 women included in the study, approximately 31% of which were postmenopausal. Black women made up around 36% of the study population. CV fat was measured an average of 3 years before the first cognitive test.

The radiodensity of PVAT was associated with worse working memory, but not other measures of cognitive function. The researchers also found that higher PVAT radiodensity was linked with lower future performance in verbal episodic memory delayed recall among Black women, but researchers emphasized that future studies should confirm this finding.

El Khoudary stated the research was limited by its small sample size. As there was a small number of Black women, it was difficult for the researchers to measure racial disparities in these outcomes. Additionally, this study relied on CT scans to measure quality, and future studies may use biopsies to further investigate how the quality of CV fat impacts cognitive outcomes, she stated.

  • Amanda D'Ambrosio is a reporter on ֱ’s enterprise & investigative team. She covers obstetrics-gynecology and other clinical news, and writes features about the U.S. healthcare system.

Disclosures

The study was supported by AHA Great River Affiliation Clinical Research Program, Department of Health and Human Services, NIH, the National Heart, Lung, and Blood Institute, the National Institute on Aging, the National Institute of Nursing Research, and the Office of Research on Women's Health.

Primary Source

North American Menopause Society

Qi M, et al "Longitudinal association between cardiovascular fat and cognitive function among midlife women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study" NAMS 2021; Abstract S-11.