OBJECTIVES Cardiovascular risk is associated with cognitive decline and this effect is attributed to brain pathology, including white matter hyperintensity (WMH) burden. Low-dose aspirin is frequently recommended for reducing vascular events. We investigated the effect of taking aspirin on the association between cardiovascular risk, WMH burden and cognitive function. STUDY DESIGN The study sample was drawn from 318 dementia-free adults aged 67-71 years. Brain magnetic resonance imaging (MRI) scans were acquired from 239 participants. MAIN OUTCOME MEASURES WMH total lesion volumes (TLV) were extracted using the automated lesion segmentation algorithm. We measured cardiovascular risk by calculating ASSIGN score. Cognitive ability was measured using a test of processing speed. We developed structural equation models to test our hypothesis. RESULTS Sixty-eight participants (47.1 % male, mean age = 68.8 years) reported that they took aspirin. The demographic measures did not differ significantly by aspirin use. Among aspirin users, there was a strong negative association between WMH TLV and cognition (β = -0.43, p-value < 0.001), while in non-users of aspirin the only significant predictor of poorer cognition was cardiovascular risk (β = -0.17, p-value = 0.001). CONCLUSIONS Aspirin use moderates the negative effect of WMH burden on cognition. Considering WMH burden in addition to cardiovascular risk could improve the prediction of cognitive decline in older adults with aspirin use.

中文翻译：

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阿司匹林可调节正常衰老过程中心血管风险、脑白质高信号总病变体积和处理速度之间的关联

目标心血管风险与认知能力下降有关，这种影响归因于大脑病理学，包括白质高信号 (WMH) 负担。低剂量阿司匹林经常被推荐用于减少血管事件。我们调查了服用阿司匹林对心血管风险、WMH 负担和认知功能之间关联的影响。研究设计 研究样本来自 318 名年龄在 67-71 岁之间的无痴呆症成年人。从 239 名参与者那里获得了脑磁共振成像 (MRI) 扫描。主要结果测量使用自动病灶分割算法提取 WMH 总病灶体积 (TLV)。我们通过计算 ASSIGN 评分来衡量心血管风险。使用处理速度测试来测量认知能力。我们开发了结构方程模型来检验我们的假设。结果 68 名参与者（47.1 % 男性，平均年龄 = 68.8 岁）报告说他们服用了阿司匹林。人口统计指标在阿司匹林使用方面没有显着差异。在阿司匹林使用者中，WMH TLV 与认知之间存在强烈的负相关（β = -0.43，p 值 < 0.001），而在非阿司匹林使用者中，认知较差的唯一重要预测因素是心血管风险（β = -0.17 ，p 值 = 0.001）。结论 阿司匹林的使用减轻了 WMH 负担对认知的负面影响。除了心血管风险之外，考虑 WMH 负担可以提高对使用阿司匹林的老年人认知能力下降的预测。WMH TLV 与认知之间存在强烈的负相关（β = -0.43，p 值 < 0.001），而在不服用阿司匹林的患者中，认知较差的唯一重要预测因子是心血管风险（β = -0.17，p 值= 0.001）。结论 阿司匹林的使用减轻了 WMH 负担对认知的负面影响。除了心血管风险之外，考虑 WMH 负担可以提高对使用阿司匹林的老年人认知能力下降的预测。WMH TLV 与认知之间存在强烈的负相关（β = -0.43，p 值 < 0.001），而在不服用阿司匹林的患者中，认知较差的唯一重要预测因子是心血管风险（β = -0.17，p 值= 0.001）。结论 阿司匹林的使用减轻了 WMH 负担对认知的负面影响。除了心血管风险之外，考虑 WMH 负担可以提高对使用阿司匹林的老年人认知能力下降的预测。