Browse Articles
Discover research articles across all indexed journals
Abstract MP44: Plasma Proteomic Signature Of BMI Reveals Heterogeneous Cardiometabolic Risk Profiles Within And Across Standard BMI Classifications
Background: The proteome is altered in obesity and proteomic signatures of BMI have been identified. However, few studies have examined differences in clinical profiles between actual and protein-predicted BMI. Hypothesis: Plasma protein-based BMI classification will better capture cardiometabolic risk compared to actual BMI classification. Methods: Data on cardiometabolic phenotypes and plasma proteins (4979 proteins via SomaScan) were available in 645 adults (56% Female, 35% Black, 17-65 yrs) from the HERITAGE Family Study. LASSO regression models with 10-fold-cross-validation were used to create a BMI proteomic signature. Protein-predicted BMI was classified into weight classes and compared to actual BMI classification to create 7 groups (underpredicted, matched, or overpredicted) ( Fig 1A ). General linear models adjusted for age, sex, race, and measured BMI were used to examine differences in cardiometabolic traits across groups. Results: The LASSO model (R 2 =0.82, RMSE=2.2) included 208 proteins. Protein-predicted BMI correlated with actual BMI at r=0.95 (p<0.0001), with a 16% misclassification rate ( Fig 1A ). Participants whose proteins underpredicted BMI class generally had more favorable cardiometabolic profiles than matched groups of the same class, while overpredicted BMI class groups showed worse cardiometabolic profiles than matched groups of the same class ( Fig 1B ). Conclusions: We identified individuals matched for BMI but with opposing proteomic signatures that differed in cardiometabolic risk profiles. Proteomic profiling may identify clinically meaningful heterogeneity in cardiometabolic health not fully captured by BMI that could potentially be used as biomarkers and/or targets of therapeutic responsiveness.
Abstract P2101: Association of circulating senescence-associated secretory phenotype (SASP) proteins with the development of frailty in late-life: the Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Emerging evidence suggests a role for cellular senescence in the pathogenesis of adverse late-life outcomes including frailty. Senescence-associated secretory phenotype (SASP) is a hallmark of senescent cells, but the extent to which circulating SASP protein levels associate with the development of frailty is not known. Hypothesis: Circulating markers of cellular senescence, reflected in the SASP, will associate with greater risk of developing frailty in late life. Methods: We studied 2,359 older adults in the community-based Atherosclerosis Risk in Communities (ARIC) cohort study who were free of HF and frailty at study Visit 5 (2011-13), had large-scale aptamer proteomics (SomaScan) measured at Visit 5, and had frailty assessed at study Visit 6 (2016-17). Protocol assessments of frailty were performed at each study visit using the Fried criteria. We assessed the association of 29 aptamers representing 26 unique SASP proteins at Visit 5 with incident frailty and frailty components at Visit 6 using multivariable logistic models adjusted for age, sex, race, and visit center. Two-sample cis-Mendelian randomization (cis-MR) was performed to evaluate potential causal effects of proteins on frailty. Results: Mean age at Visit 5 was 74±5 years, 57% were women, and 16% reported black race. Over the 5 years between Visits 5 and 6, 152 participants developed frailty. Seven of 26 SASP proteins were associated with the development of frailty at FDR significance (FDR-adjusted p < 0.05 ; Figure ): five with higher risk of frailty (CST3, GDF15, CTSZ, CTSD, HSPA1A) and two with lower risk (GSN, SERPING1). These proteins demonstrated the most consistent associations with low energy, while GDF15, CST3, and CTSZ were significantly associated with all five frailty components (FDR-adjusted p < 0.05). In cis-MR analysis, GDF15 and SERPING1 showed potential causal effects on frailty. Conclusion: Higher circulating levels of a subset of senescence-associated proteins are associated with greater risk of developing frailty in late life, two of which may have causal effects on frailty. These findings support a potential role for cellular senescence in the pathogenesis of the frailty syndrome.
Abstract P3036: Predicting Risk of Obesity-Related Outcomes in People with Obesity or Overweight: the Role of Social Risk Factors
Introduction: Social risk factors have been shown to be related to overweight/obesity and developing related poor health outcomes. Prediction models for obesity-related outcomes in people with obesity or overweight developed within clinical care settings can be used in decision making to identify individual patient risk for poor outcomes. There have been calls to link person-level or census tract level social risk factors to Electronic Health Record (EHR) data for use in clinical decision-making. However, such methods have not been fully developed and more information is needed regarding which social risk factors are relevant for predicting risk. Objective: To examine whether adding primary payer type and publicly available zip code level composite (Area Deprivation Index; National Walk Index; Rural-urban Commuting Area) or non-composite (poverty rate, low-income tract, median family income, population density) risk factors improve risk prediction model fit and accuracy. Methods: EHR data for 837,373 eligible patients (18-80 years, BMI 25-80 kg/m 2 , with 5-digit zip code to link to census data) were utilized to determine the value of adding social risk factors to validated prediction models developed for use in clinical care settings. Outcomes were times to event for type 2 diabetes (T2DM), atherosclerotic cardiovascular disease, heart failure, sleep apnea, and obesity-related cancer. Models were fit using a multi-level Cox regression with a competing risk of death. Adaptive LASSO was applied to add social risk factors to existing models. Full models with all significant social risk variables and reduced models in which highly correlated social risk variables were removed, were examined. Assessments of model fit were done utilizing the AIC/BIC and Harrel’s C-index was calculated to assess predictive ability. Results: Several models retained some social risk factors. The model for T2DM was the only one in which social risk factors did not improve the EHR-only models, though increases in Harrel’s C-index values were small (<0.01) for the other models with social risk factors added. Conclusions: Individual and composite zip code level social risk factors were statistically significantly associated with all outcomes and improved the models, except for T2DM, but did not meaningfully improve predictive ability. Additional studies are warranted examining effects of social risk closer to, or at, the individual level, such as census block or neighborhood.
Convergent validity of 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) among people with neck pain
Objective To explore the convergent validity of 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) comparing it to Neck Disability Index (NDI). Design Cross-sectional cohort study. Subjects/Patients 962 patients visiting a university outpatient Physical and Rehabilitation Medicine Clinic due to musculoskeletal complaints. Methods Spearman´s rank correlation between WHODAS 2.0 and NDI. Results The average age was 49.2 (SD 14.5) years, 67% were women. Of all the possible 143 correlations between WHODAS 2.0 and NDI, 99 (69%) were positive, significant and strong or, at least, moderate. The correlation between the composite scores of two scales was strong. The weakest correlations were seen for the NDI items ‘pain intensity and ‘headaches’. Conclusion Most of the items and the composite scores of the WHODAS and the NDI demonstrated significant positive correlations. Pain intensity, as defined by the NDI, did not correlate with disability severity measured by the WHODAS 2.0. Also, the NDI items ‘headaches’ and ‘sleeping’ were associated with the WHODAS 2.0 only loosely. It seems that one of these two scales may not directly be substituted by another. When used simultaneously, The WHODAS and the NDI may complement each other covering comprehensively the different dimensions of functioning among people with neck pain.
Abstract MP78: Device-Based Assessment of 24-Hour Activity Across Three Trimesters of Pregnancy: The Pregnancy 24/7 Cohort Study
Introduction: The 24-hour activity cycle, including moderate-to-vigorous intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behavior (SED), and sleep, is increasingly recognized as critical for health. However, little is known about 24-hour activity during pregnancy. This is an important research gap given that these behaviors are modifiable and individually related to maternal and child cardiovascular health outcomes. The purpose of this study was to characterize 24-hour activity across pregnancy using gold standard, device-based measures and examine differences by trimester. Hypothesis: We hypothesized there would be varying patterns of 24-hour activity across pregnancy trimesters. Methods: The ongoing Pregnancy 24/7 multi-site cohort study was conducted to examine associations of 24-hour activity across pregnancy trimesters with hypertensive disorders of pregnancy and other adverse pregnancy outcomes. Participants were instructed to wear the activPAL3 micro (MVPA, LPA, and SED) and the Actiwatch Spectrum Plus (sleep) concurrently for 24 hours x 7 full days in each trimester of pregnancy and to complete a log denoting non-wear and sleep times. Data sources were integrated using PAL Technologies software and a customized R program and descriptive statistics were calculated for each component of 24-hour activity, including the percentage of participants meeting guidelines (when applicable). Differences across trimesters were examined using nested linear or generalized mixed models. Results: A total of n=474 participants to date (mean age 30.8 years ± 4.3, 15.6% Underrepresented Minority) wore both devices in at least one trimester. Time spent in each behavior significantly differed across trimesters (see Table ). MVPA and sleep were highest in the first trimester, while LPA was highest and SED lowest in the second trimester. The percentage of women meeting MVPA guidelines decreased from 54.8% to 44.2%, while the percentage meeting sleep guidelines (time attempting to sleep) increased from 63.2% to 76.1% across trimesters. Meeting a SED threshold of <10 hours/day did not differ across pregnancy trimesters. Conclusions: Declining levels of MVPA during pregnancy suggest a need for tailored health promotion interventions. It may be more feasible to target other components of 24-hour activity during pregnancy, such as decreasing SED by increasing LPA.
Abstract 060: Associations of Neighborhood Walkability with Baseline Physical Activity and Sedentary Time among US South Asian Adults from the SAHELI Randomized Clinical Trial
Introduction: High neighborhood walkability, defined as presence of crosswalks, sidewalks, and parks, is associated with higher physical activity (PA) and lower sedentary time (ST) among United States (US) adults. The associations between neighborhood walkability, PA, and ST have not been studied among US South Asians adults, a group which experiences significantly higher cardiovascular disease (CVD) mortality compared to other race-ethnic groups. Methods: The SAHELI clinical trial randomized South Asian adults from the Chicago, IL metro area (18-65 years with CVD risk factors) to a 16-week lifestyle intervention versus a control group between 2018-2023. Baseline PA and ST were measured by an Actigraph worn by participants for 7 consecutive days. Moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and ST were defined by Troiano cut points. Neighborhood was defined by a 500-meter radius around participants’ home address. Neighborhood walkability measures included: the National Walkability Index (measured at the US Census block level), total number of crosswalks, total number of sidewalks, and percentage of neighborhood which contained a park, all measured by Google Street View. In separate models, multivariate linear regression evaluated the association between each neighborhood walkability measure and baseline MVPA, LPA, and ST, adjusting for age, sex, country-of-origin, years in US, and Actigraph wear time. Results: Participants from SAHELI with valid Actigraph data (defined as at least 600 min/day of wear time for >3 days) and geocoded neighborhood walkability data were included (N=432; 59% female, 98% immigrant, 79% Indian origin). Mean±SD MVPA was 24±19 min/day, LPA was 299±95 min/day, and ST was 564±136 min/day. Distribution of neighborhood walkability variables are shown in Figure . Neighborhood walkability exposures were not associated with MVPA. The National Walkability Index, total number of crosswalks, and total number of sidewalks were significantly associated with higher LPA and lower ST in maximally-adjusted models ( Figure ). The percentage of neighborhood containing a park was not associated with LPA or ST. Conclusion: National Walkability Index, number of neighborhood crosswalks and sidewalks were significantly associated with higher LPA and lower ST, but not with MVPA. Neighborhood walkability may be important to consider when designing CVD prevention interventions that promote PA and minimize ST among US South Asians.
Abstract P3071: Trends in blood pressure among Veterans who initiated antihypertensive medication from 2014 to 2020
Introduction: The prevalence of blood pressure (BP) control of <140/90 mmHg in the Veterans Health Administration (VHA) in the early 2000s was high (>75%). However, the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline and COVID-19 pandemic may have affected pre-and-post treatment BP. Research Question: Were there changes in pre-and-post treatment systolic BP (SBP, mmHg) and control prevalence relative to the 2017 BP guidelines and COVID-19 pandemic? Methods: Our retrospective study included Veterans initiating antihypertensive medication in VHA outpatient settings from 11/13/2014-11/12/2020. Using the first antihypertensive prescription fill date, Veterans were placed into one of 4 cohorts (Panel A): 1) pre-ACC/AHA 2017 guideline; 2) first year post-guideline; 3) second year post-guideline (included first confirmed US COVID case); and 4) during-COVID. Linear and logisitc regression estimated age- and dropout-adjusted mean SBP levels and likelihood of BP control at 1 year. Results: Among 94,551 Veterans included (mean age 65 years, 94% male, 69% non-Hispanic White), 68.5% had pre-treatment SBP ≥130. In this group, over time, the mean pre-treatment SBP decreased and post-treatment SBP increased (Panel B). Overall, the respective proportion in each cohort with 1-year BP control of <130/80 was 31.3%, 33.1%, 32.5%, and 31.5% (p-trend=0.16) (Panel C). Assessment of 1-year BP control of <140/90 was 72.7%, 74,4%, 74.0%, and 71.8% (p-trend=0.91). The prevalence of 1-year BP control pre- and during-COVID was 31.8% vs 31.5% (p=0.44). Conclusions: Mean post-treatment SBP levels and 1-year BP control prevalence were stable after the release of the 2017 guideline and during the COVID-19 pandemic.
Examining safety of cardiac surgery in patients with preoperative cardiac arrest
Background Although postoperative cardiac arrest is a well-studied complication of cardiac surgery, few guidelines exist regarding timing of surgery in preoperative cardiac arrest (pCA). We examined the association between delayed timing of operation and postoperative outcomes following cardiac surgery in a large cohort of pCA. Methods Adults with a diagnosis of pCA undergoing a cardiac operation were identified in the 2016-2020 National Inpatient Sample. Those requiring surgery within 24 hours fo cardiac arrest were excluded. Patients who underwent a cardiac procedure after 5 days of cardiopulmonary resuscitation were classified as Delayed (others: Early). Multivariable regression models were constructed to evaluate associations between delayed timing of surgery with in-hospital mortality, postoperative complications, hospitalization duration, and costs. Results Of an estimated 9,240 patients meeting study criteria, 4,860 (52.6%) received delayed cardiac surgery. Following entropy balancing, delayed surgery was significantly associated with decreased odds of in-hospital mortality (Adjusted Odds Ratio [AOR] 0.75, 95% Confidence Interval [CI] 0.58 – 0.97). However, delayed operation demonstrated greater odds of postoperative thromboembolic (AOR 1.44, 95% CI 1.02 – 2.04), and infectious (AOR 1.65, 95% CI 1.31 – 2.08) complications. Notably, delay did not alter odds of neurologic complication, and was linked to a decrement in per-day costs (β -$2,100, 95% CI -2,600 – −1,700). Conclusions While preoperative cardiac arrest remains challenging, the present study demonstrates the safety profile of delaying cardiac operation among patients tolerating at least 24 hours of a delay to surgery. Future studies are needed to elucidate the factors associated with favorable outcomes in this population.
Abstract P3116: Household Food Insecurity and Adiposity Changes Among Adolescents: A Longitudinal Study of Gender-Specific Outcomes in the Greater Baton Rouge Area
Background: Food insecurity has been consistently linked with obesity in adults, but research findings have been less conclusive among adolescents. Previous studies have suggested that food insecurity places adolescents at a higher risk for adverse health outcomes, with obesity being a significant concern. Objective: To examine the relationship between baseline household food insecurity and adiposity changes over two years among Louisiana adolescents aged 10 to 16 in the Baton Rouge, Louisiana metropolitan area. Methods: Multilevel longitudinal data were collected from June 2016 to August 2018 during baseline and follow-up assessments conducted within the Translational Investigation of Growth and Everyday Routines in Kids study. Adolescent adiposity and body composition data were obtained using body imaging (i.e., dual-energy X-ray absorptiometry and abdominal magnetic resonance imaging) and anthropometric measures at baseline and follow-up. Multivariable multilevel linear regression models, adjusted for demographic and physiological variables, assessed the relationship between baseline household food security status and changes in adiposity outcomes. Results: The analytic sample consisted of 216 adolescents with a mean age of 12.9±1.9; 47.7% were male, 40.7% identified as African American or Hispanic, and 38.4% had obesity at baseline. Twenty-two percent of the sample reported food insecurity at baseline. Compared to food-secure adolescents, food-insecure adolescents experienced significantly larger increases in all adiposity measures between baseline and follow-up (percentage of the 95th BMI percentile: b=7.3, p<0.01; waist circumference: b=3.9, p<0.05; total body fat percentage: b=3.2, p<0.01; and abdominal visceral adipose tissue: b=0.2, p<0.01). Similar results were found among girls; however, among boys, only change in abdominal visceral adipose tissue was higher in food insecure vs food secure boys (b=0.2, p<0.05). Conclusion: This study provides support for the longitudinal association between household food insecurity and increased adiposity in adolescents, with notable gender differences. The main findings show household food insecurity is associated with greater changes in adiposity among girls than boys. These findings underscore the importance of addressing food insecurity as part of comprehensive obesity prevention strategies. Moreover, they highlight the need for gender-specific approaches in tackling this complex public health issue.
Abstract P1116: The DASH Dietary Pattern and Risk of Cardiovascular Disease Mortality During 1988-2019 in US Adults: A Population-Based Cohort Study
Introduction: The Dietary Approaches to Stop Hypertension (DASH) diet reduces cardiovascular disease (CVD) risk factors in clinical trials and has been associated with reduced CVD risk. However, evidence on reduced CVD mortality outcomes has yet to be observed in the National Health and Nutrition Examination Survey (NHANES), a representative sample of the US population, possibly due to an insufficient follow-up in early analyses and a limited dietary exposure assessment. Objective: To examine the association between the DASH dietary pattern and CVD mortality with a longer follow-up using a food-based score and a more robust dietary exposure assessment. Methods: A total of 13,586 nonpregnant adults without a history of CVD were included from NHANES (1988-1994). Diet was assessed by a 24-hour dietary recall supplemented with a food frequency questionnaire at baseline using the DASH-style diet adherence score (DASH score) with positive points for servings of fruits, vegetables, nuts and legumes, whole grains, and low-fat dairy products, and negative points for total dietary sodium, servings of red and processed meats, and sweetened beverages (range, 8-40 points). Mortality data were obtained from National Death Index records until 31 December 2019. Weighted Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). The primary outcome was CVD-mortality. Other mortality outcomes included coronary heart disease (CHD), stroke, and all-cause mortality. Results: During a mean follow-up of 23-years, 1,751 CVD deaths, including 1,416 CHD, 335 stroke deaths and 5,202 all-cause deaths were documented over 311,826 person-years. After multivariable adjustments comparing the highest to lowest tertiles of the DASH score, participants with higher DASH scores were associated with 24% (HR: 0.76 [95% CI: 0.61, 0.94]), 25% (0.75 [0.60, 0.95]) and 19% (0.82 [0.71, 0.94]) lower risk of CVD, CHD, and all-cause mortality, respectively. There was no association with stroke mortality (0.80 [0.48, 1.38]). An increase in DASH score by 10-points was associated with a 20% (0.80 [0.70, 0.93]), 23% (0.77 [0.65, 0.90]), and 18% (0.82 [0.75, 0.90]) lower risk of CVD, CHD, and all-cause mortality, respectively. Conclusion: Among US adults, greater adherence to a food-based DASH score was inversely associated with CVD, CHD, and all-cause mortality.
Abstract P3127: Loneliness and Social Isolation from Reduced Activities Increase Ischemic Heart Disease Risk via Metabolic and Behavioral Mediators: Evidence from Mendelian Randomization Study
Introduction: Observational studies have linked loneliness or social isolation (SI) to ischemic heart disease (IHD), but results are inconsistent. Moreover, modifiable risk factors mediating the causal effects remain unclear. Hypothesis: loneliness and SI causally increase IHD risk, with metabolic and behavioral factors acting as key mediators. Methods: Using genetic instruments derived from summary-level Genome-Wide Association Studies data of European ancestry, we performed a bidirectional two-sample Mendelian Randomization (MR) study to estimate causal effects between loneliness (N=487,647) or SI and IHD (60,801 cases and 123,504 controls). SI traits included living alone (N=459,988), fewer social activities (N=459,830), and fewer contact with friends or family (N=461,369). Five subtypes of social activities were further analyzed, including sports club or gym, pub or social club, religious group, adult education class, or other group activities. Subsequently, a network MR study was conducted to evaluate the potential mediating effects of 20 candidate mediators and calculate their mediated proportions. Results: Loneliness was causally associated with IHD (OR 2.129; 95% CI, 1.380 to 3.285), mediated by body fat percentage, waist-hip ratio, total cholesterol and LDL-C. Regarding SI traits, fewer social activities increased IHD risk (OR, 1.815; 95%CI, 1.189 to 2.772), and only sports club or gym had protected against IHD (OR, 0.333; 95%CI, 0.204 to 0.542). No evidence showed causality between living alone or contact frequency and IHD. Smoking cessation, HDL-C, triglycerides, hypertension and fasting insulin mediated the causal pathway from fewer social activities to IHD. Moreover, no evidence indicated the reverse causality of IHD with loneliness or SI. Results were robust in sensitivity analyses. Conclusions: More attention should be paid to individuals who feel lonely or have fewer social activities for prevention of IHD, with several modifiable mediators as prioritized targets.
Porphyromonas gingivalis outer membrane vesicles alter cortical neurons and Tau phosphorylation in the embryonic mouse brain
Porphyromonas gingivalis (Pg) is an oral bacterial pathogen that has been associated with systemic inflammation and adverse pregnancy outcomes such as low birth weight and pre-term birth. Pg drives these sequelae through virulence factors decorating the outer membrane that are present on non-replicative outer membrane vesicles (OMV) that are suspected to be transmitted systemically. Given that Pg abundance can increase during pregnancy, it is not well known whether Pg-OMV can have deleterious effects on the brain of the developing fetus. We tested this possibility by treating pregnant C57/Bl6 mice with PBS (control) and OMV from ATCC 33277 by tail vein injection every other day from gestational age 3 to 17. At gestational age 18.5, we measured dam and pup weights and collected pup brains to quantify changes in inflammation, cortical neuron density, and Tau phosphorylated at Thr231. Dam and pup weights were not altered by Pg-OMV exposure, but pup brain weight was significantly decreased in the Pg-OMV treatment group. We found a significant increase of Iba-1, indicative of microglia activation, although the overall levels of IL-1β, IL-6, TNFα, IL-4, IL-10, and TGFβ mRNA transcripts were not different between the treatment groups. Differences in IL-1β, IL-6, and TNFα concentrations by ELISA showed IL-6 was significantly lower in Pg-OMV brains. Cortical neuron density was modified by treatment with Pg-OMV as immunofluorescence showed significant decreases in Cux1 and SatB2. Overall p-Tau Thr231 was increased in the brains of pups whose mothers were exposed to Pg-OMV. Together these results demonstrate that Pg-OMV can significantly modify the embryonic brain and suggests that Pg may impact offspring development via multiple mechanisms.
Abstract P3151: Association Between Life’s Essential 8 and Cardiovascular Disease by Depression Status
Cardiovascular health (CVH), as measured by the American Heart Association's Life’s Essential 8 (LE8) metrics, plays a vital role in determining cardiovascular disease (CVD) risk. Depression is also known to have adverse effects on CVD outcomes and may further complicate this relationship. Thus, this study assesses the relationship between LE8 and CVD overall, and by depression status. We hypothesize that higher LE8 scores are associated with lower odds of CVD, and that depression status may modify this relationship. This cross-sectional study employed secondary data analysis using National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2018, with an analytic sample size of 14,848 participants (age ≥ 20 years). Multivariable logistic regression analyses, incorporating survey weights, for CVD outcome (i.e., stroke, heart attack, angina, coronary heart disease, heart failure) were performed as a function of LE8 scores (high/moderate/low CVH) while adjusting for potential confounders. We also assessed for effect measure modification (EMM) by depression status using the PHQ-9 scores by including product terms between LE8 scores and depression in the adjusted model. The adjusted odds ratios (OR) for CVD among participants with high and moderate compared to low LE8 scores were 0.38 (95% CI: 0.19-0.75) and 0.52 (95% CI: 0.42-0.63), respectively. EMM assessment by depression status indicated strong negative associations between higher LE8 scores and CVD in both groups. Specifically, the adjusted ORs were 0.42 (95% CI: 0.21-0.83) for those reporting no depression and 0.06 (95% CI: 0.01-0.60) for those with depression. We found a clear negative relationship between LE8 scores and CVD, with higher LE8 scores associated with lower odds of CVD compared to the lower LE8 scores group. This protective relationship was particularly profound among individuals with higher levels of depressive symptoms. These findings highlight the importance of promoting CVH to mitigate the adverse effects of depression on CVD outcomes. Additional prospective studies should be conducted to establish the temporality of these associations between LE8 scores and CVD outcomes among individuals with depression.
Abstract 007: Associations of Accelerometer Measures of Physical Activity and Sedentary Behavior with Alzheimer’s Disease Related Dementias and Vascular Dementias Classified Using Medicare Claims Data Among Older Black, Hispanic and White Women: The Objective Physical Activity and Cardiovascular Health Study
Introduction: Higher amounts of physical activity (PA) have been shown to be associated with lower risk of Alzheimer’s disease related dementias (ADRD), however few studies have prospectively examined accelerometer measures of PA and sitting with ADRD and specifically vascular dementias (VD) among older diverse women. Methods: Older postmenopausal women (n=5417; mean age=78 ± 7 years; 33% Black, 17% Hispanic) in the Objective Physical Activity and Cardiovascular Health Study without prior ADRD wore accelerometers for 7 days in May 2012-April 2014 and were followed through December 31, 2021. Incident ADRD was classified using Medicare Claims data, allowing for identification of events among older Black, Hispanic or Latina, and White women. Multivariable Cox models estimated hazard ratios (HR) and 95% confidence intervals (CI) for total PA, light PA (LPA), moderate-to-vigorous intensity PA (MVPA), steps/day, total sitting time, and mean sitting bout duration (MSBD) with ADRD and VD adjusting for age, race and ethnicity, education, alcohol, smoking, hypertension, diabetes, physical functioning, and body mass index (BMI). We additionally carried out stratified analysis across covariates. Results: There were 1143 ADRD events, including 187 VD events, during a median follow-up of 8.6 years. The HR (95% CI; P-trend) for ADRD and VD for each 1 standard deviation (SD) increment was 0.83 (0.69-1.00; 0.04) and 0.77 (0.48-1.25; 0.70) for total PA (SD=90 minutes/day), 0.58 (0.48-0.71; <0.001) and 0.61 (0.38-0.99; 0.02) for MVPA (SD=34 minutes/day), 0.53 (0.43-0.65; <0.001) and 0.57 (0.34-0.97; 0.01) for steps/day (SD=2051 steps/day), and 1.15 (0.95-1.38; 0.03) and 0.84 (0.52-1.37; 0.72) total sitting time (SD=102 minutes/day). Associations for steps with ADRD were similar among Black (HR=0.69, 95% CI=0.57-0.85), White (HR=0.70, 95% CI=0.61-0.81) and Hispanic or Latina women (HR=0.80, 95% CI=0.63-1.01, P-interaction=0.32). LPA and MSBD were not associated with ADRD or VD. Conclusions: Higher MVPA and steps/day were associated with lower ADRD and VD risk while higher total sitting time was associated with higher ADRD risk, supporting interventions aimed at increasing PA and reducing SB for ADRD prevention in diverse populations.
Abstract P3141: Psychological Health and Life’s Essential 8 Cardiovascular Health Risk among Women of Reproductive Age
Introduction: Few studies have explored how stress, anxiety, and depression impact cardiovascular health among women of reproductive age. This study examines the relationship between psychological health and cardiovascular risk factors among community-enrolled participants and those from the American Heart Association’s Research Goes Red (RGR) registry. Methods: We conducted a cross-sectional analysis of participants from the RGR Registry and the SAFE HEART study who completed cardiovascular and psychological health questionnaires. Psychological health risk was assessed using the Perceived Stress Scale (high stress, ≥8), Generalized Anxiety Disorder scale (high anxiety, ≥3), and Patient Health Questionnaire (high depression, ≥3). Dependent variables included Life’s Essential 8 cardiovascular health metrics: self-reported hypertension, diabetes, hyperlipidemia, overweight/obesity (≥25 kg/m2), poor diet (less than 5 servings of fruits/vegetables), low physical activity (<150 minutes/week, moderate), inadequate sleep (<7 or >9 hours), and smoking (current or history of 100 cigarettes). Logistic regression models were used to assess associations between psychological health and cardiovascular outcomes, adjusting for social risk covariates. Results: In this cross-sectional study of 457 women aged 18-44 the mean age was 30 years ± 5.7, with 45.51% Black adults, 87.30% had at least college education, 66.52% were married or living with a partner and 71.12% were employed. After adjusting for covariates, high stress was associated with increased odds of hypertension (adjusted odds ratio [aOR] = 2.08, 95% CI: 1.29-3.36), hyperlipidemia (aOR = 2.78, 95% CI: 1.74-4.46), smoking (aOR = 2.21, 95% CI: 1.40-3.60) and lower odds of poor diet (aOR = 0.62, 95% CI: 0.38-0.98). High depression was similarly associated with hypertension (aOR = 1.97, 95% CI: 1.20-3.25), hyperlipidemia (aOR = 2.49, 95% CI: 1.52-4.06), smoking (aOR = 4.61, 95% CI: 2.75-7.74), overweight/obesity (aOR = 2.41, 95% CI: 1.40-4.16), low physical activity (aOR = 2.45, 95% CI: 1.42-4.22), and poor diet (aOR = 3.13, 95% CI: 1.75-5.61). High anxiety was also associated with hyperlipidemia (aOR = 2.09, 95% CI: 1.30-3.39) and smoking (aOR = 1.79, 95% CI: 1.08-2.96). Conclusion: We found significant associations between psychological health and cardiovascular risk factors among women of reproductive age. Interventions to improve psychological health may improve cardiovascular health and prevent adverse pregnancy outcomes.
STEM ability perceptions, basic needs satisfaction, and intrinsic motivation in adolescents: The role of inclusive perceptions in self-determination
Current work suggests that basic psychological needs are related to higher intrinsic motivation, which in turn, can promote more positive academic outcomes. However, few studies have examined how perceptions around one’s abilities in science, engineering, technology, and math (STEM) are related to intrinsic motivation and what role needs satisfaction plays in this association. This study assessed adolescents’ (N = 285, 56.1% female, Mage = 15.76 years, SD = 1.24) STEM ability perceptions, basic needs satisfaction, and intrinsic motivation. A path analysis was used to examine the association between STEM ability perceptions, basic needs satisfaction, and intrinsic motivation in adolescents. Inclusive perceptions of the STEM abilities of historically underrepresented groups (i.e., girls and minoritized ethnicities) were positively associated with basic needs satisfaction and basic needs satisfaction was positively associated with intrinsic motivation. There was also a positive indirect effect from inclusive perceptions of STEM abilities to intrinsic motivation through basic needs satisfaction. These findings suggest that schools should focus on promoting inclusive perceptions in order to bolster adolescents’ basic needs satisfaction, which could have carry-on effects on intrinsic motivation.
Abstract P3160: The Effect of Early-Life Area-Level Socioeconomic Deprivation on Cognitive Function in Middle-Aged Adults: Findings from the Bogalusa Heart Study
Background: Area-level socioeconomic deprivation is linked to cognitive impairment in older adults, but its impact from middle age is unclear. Evidence on the early-life deprivation effect on midlife cognitive function (CF) is limited. Objective: To investigate the effect of early-life Area Deprivation Index (ADI), on CF in middle-aged adults Methods: We assessed the association between early-life ADI and midlife CF in 1,099 subjects from the Bogalusa Heart Study (58.0% Whites, 42.0% Blacks, mean age at ADI: 12.6±5.9, mean age at CF: 48.7±5.0). Census data for 17 block-group variables were collected, including education, poverty, income, employment, and housing. Home ownership was excluded due to a factor loading below 0.3, leaving 16 variables for ADI calculation through factor analysis. The ADI was divided into quintiles, with the 1st quintile as the least deprived and 5th as most. CF was assessed through tests measuring episodic memory, working memory, attention, graphomotor information processing speed (GIPS), and global CF. Associations between ADI and CF were evaluated using a generalized estimation equation, adjusting for age at first exam, sex, race, year, and education. Interaction terms of race and education with ADI quintiles were tested. Results: The independent t-test showed Blacks had a higher ADI than Whites, indicating greater deprivation (0.81±0.58 vs. –0.60±0.80, p <0.001). Global CF decreased in the 5th ADI quintile compared to the 1st (β=–0.002 standardized unit [SE: 0.001], p =0.001), with a downward trend across quintiles ( p =0.002). Episodic memory, working memory, attention, and GIPS also decreased as the quintile of ADI increased ( p <0.001). Interaction terms with education showed significant negative effect on CF among high school graduates (1 st vs. 4 th quintile: β=–0.004 [SE: 0.002]), and those with education beyond high school (1 st vs. 5 th quintile: β=–0.004 [SE: 0.002]), but not among less than high school (1 st vs. 5 th quintile: β=–0.003 [SE: 0.001]; p for interaction: 0.011). Interactions between ADI quintiles and race were not significant. Conclusion: Higher early-life ADI was associated with lower midlife CF, with a decline observed in CF in the most deprived quintile, although effect sizes were modest. The strongest negative impact was observed among those with high school education or higher. Keywords area deprivation index; cognition; middle-aged adults
Abstract P2093: Chronic Kidney Disease Severity and Incident Cognitive Impairment in Patients with Chronic Kidney Disease: Findings from the Chronic Renal Insufficiency Cohort
Background: Patients with chronic kidney disease (CKD) face a disproportionate burden of dementia compared to the general population. However, prospective associations between kidney function and cognitive impairment remain inconsistent and have not been exclusively evaluated in CKD. Methods: This analysis included 4,261 CKD patients from the Chronic Renal Insufficiency Cohort (CRIC). CKD severity was defined using standard estimated glomerular filtration rate (eGFR) and urinary protein to creatinine ratio (UPCR) thresholds. Global cognition and domains of verbal memory, attention/processing speed, and executive function were assessed longitudinally using the modified mini-mental status examination (3MS), Buschke Selective Reminding test, Trail Making Test A (TMTA), and Trail Making Test B (TMTB), respectively. For each test, impairment was defined as a score at least one standard deviation (SD) worse than the cohort mean at baseline. Cox proportional hazard models assessed associations between baseline CKD severity and time-to-cognitive impairment, adjusting for demographic and lifestyle risk factors, clinical measures, medications, and baseline cognition. Restricted cubic splines evaluated non-linear relations of both eGFR and UPCR with cognitive impairment. Results: Among CRIC participants with a mean age 59.6 years and median follow-up of 14.7 years, we observed significant, dose-response associations between increasing CKD severity, based on both eGFR and UPCR, and incident global cognitive impairment. Compared to those with stage G2 CKD (eGFR=60-89), patients with stage G4/G5 CKD (eGFR<30) had a 36% increased risk of cognitive impairment (HR=1.36; 95% CI=1.00, 1.86; P linear =0.03). Similarly, patients with UPCR>500 mg/g had a 26% increased risk compared to those with UPCR<150 mg/g (HR=1.26; 95% CI=0.99, 1.59; P linear =0.04). Increased CKD severity based on eGFR was significantly associated with attention impairment (G4/G5 vs. G2 HR=1.49; 95% CI=1.03, 2.14; P linear =0.04). Spline analyses revealed linear relationships between declining eGFR and impairment in global cognition (P=0.007) and attention (P=0.005), and between increasing UPCR and impairment in attention (P=0.015) and executive function (P=0.036; Figure ). No evidence of non-linear relationships were observed. Conclusion: More severe CKD, reflected by lower eGFR and higher UPCR, was prospectively associated with impairment in global cognition and specific cognitive domains.
Abstract 047: Plasma metabolic signatures of healthy diets and healthspan: an integrative analysis of metabolomics and genetics among 12,478 US adults with 32 years of follow-up
Background: Extending the healthspan – years of lived without disease – is a public health priority. Healthy diets have been linked to lower chronic disease risk, but the underlying mechanisms are largely unknown. We have previously identified plasma multi-metabolite signatures that measure intakes and metabolic responses to different dietary patterns. Hypothesis: Plasma metabolic signatures of heathy diets are associated with longer healthspan. Methods: We studied 12,478 participants from Nurses’ Health Studies and Health Professional Follow-up Study who were free of baseline chronic diseases. Diet was assessed by a food frequency questionnaire and indices for 3 recommendation-based, 3 plant-based, and 2 mechanism-based diets, were calculated. Plasma metabolome was profiled by liquid chromatography-mass spectrometry. Metabolic signatures for 8 dietary patterns, each based on 38-66 metabolites, were derived using elastic net model from our prior study. A polygenetic risk score (PRS) of shortened healthspan was calculated based on a published genome-wide association study using LDpred2. Cox regression was used to test associations with healthspan, which ended at the time of first onset of any of 11 major chronic diseases including cardiovascular disease. Results: During up to 32.4 years of follow-up, 6,021 individuals developed at least one chronic disease within an average of 23.8 years. In multivariable analyses, per standard deviation (SD) increase in metabolic signatures of all 5 examined healthful diets (e.g., Mediterranean diet) were associated with a lower risk of shortened healthspan (hazard ratio [HR]: 0.83-0.88; P < 6e-8), whereas signatures of 3 unhealthful diets (e.g., proinflammatory diet) were associated with a higher risk of shortened healthspan (HR: 1.08-1.26; P < 1e-3) ( Fig. A ). These associations persisted after adjusting for their corresponding dietary indices. While the derived PRS significantly predicted the genetic risk for any chronic diseases ( Fig. B ), the associations between metabolic signatures of diets and healthspan were not modified by such a genetic burden ( P-interaction >0.05; Fig. C ). Conclusions Plasma metabolic signatures that reflect intakes and metabolic responses to heathy diets are associated with longer healthspan, regardless of genetic burden for chronic diseases.
LLM-FMS: A fine-grained dataset for functional movement screen action quality assessment
The Functional Movement Screen (FMS) is a critical tool for assessing an individual’s basic motor abilities, aiming to prevent sports injuries. However, current automated FMS evaluation is based on deep learning methods, and the evaluation of actions is limited to rank scoring, which lacks fine-grained feedback suggestions and has poor interpretability. This limitation prevents the effective application of automated FMS evaluation for injury prevention and rehabilitation. We develop a fine-grained, hierarchical FMS dataset, LLM-FMS, derived from FMS videos and enriched with detailed, hierarchical action annotations. This dataset comprises 1812 action keyframe images from 45 subjects, encompassing 15 action representations of seven FMS actions. Each action includes a score, scoring criteria, and weight data for body parts. To our extensive knowledge, LLM-FMS is the first fine-grained fitness action dataset for action evaluation task. Additionally, a novel framework for action quality assessment based on large language models (LLMs) is proposed, designed to enhance the interpretability of FMS evaluations. Our method integrates expert rules, utilizes RTMPose to extract key skeletal-level action features from key frames, and inputs prompts into the LLM, enabling it to infer scores and provide detailed rationales. Experimental results demonstrate that our approach significantly outperforms existing methods while offering superior interpretability. Experimental results demonstrate that our approach outperforms existing methods in terms of accuracy and interpretability, with a substantial increase in the clarity and detail of the rationales provided. These findings highlight the potential of our framework for fine-grained action quality assessment with the aid of LLMs.