Web‐based assessment of cardiovascular risk factors and cognition in older adults: Findings from the Brain eHealth feasibility study: Epidemiology / Risk and protective factors in MCI and dementia

Background Cardiovascular risk factors (CVRFs) are linked to cognitive aging. Most studies rely on lengthy in‐person assessments, and it is unclear if web‐based platforms can be used to detect the contribution of risk factors, including CVRFs, to cognitive aging offering a more pragmatic and low cost approach. Method We recruited 239 adults who were enrolled in the Health eHeart project in order to conduct the Brain eHealth study, a mobile health feasibility study of web‐based measurement tools in adults age ≥50. CVRFs were identified based on health surveys from the Health eHeart study using the Eureka Research platform between March 2013, and February 2019, and included hypertension, high cholesterol, diabetes, and atrial fibrillation. After an average of 3 years participants completed a web‐based cognitive assessment with the BrainHQ platform (POSIT Science) that assessed 3 cognitive domains: episodic memory, working memory, and executive function. We used linear regression models to examine the association between CVRFs and cognitive function. Result Among the 239 participants (mean age, 62.7±8.8, 43% female, 89% white), CVRF prevalence was 54% for high cholesterol, 44% for hypertension, 12% for atrial fibrillation, and 7% for diabetes. In multivariable models adjusted for age, race/ethnicity, and sex, atrial fibrillation was associated with poor working memory (β = ‐0.52, 95%CI ‐0.92,‐0.11) and worse episodic memory (β = ‐0.26, 95%CI ‐0.42,‐0.08), and hypertension was associated with worse episodic memory (β = ‐0.25, 95%CI ‐0.42, ‐0.08). There was no association for diabetes or high cholesterol. In a sensitivity analysis, we further adjusted for motor speed processing, which led to similar results. Conclusion Results of this feasibility study suggest that web‐based tools may be used to detect the contribution of CVRFs, especially atrial fibrillation and hypertension to cognitive function in older adults. The potential of these mobile measurement tools to track the relationship between older adults’ cardiovascular health and cognitive aging should be further investigated in a larger study.