P4‐167: Cerebrovascular Disease Burden is Associated With Poor Cognitive Function in Elderly Community‐Dwelling Subjects With No Cognitive Impairment and Cognitive Impairment‐No Dementia

Cerebrovascular disease (CeVD) is a major contributor to cognitive impairment and dementia. Few studies have investigated the association between presence of CeVD and cognitive function in dementia-free community dwelling subjects, hence we have done so in 2 groups: no cognitive impairment (NCI) and cognitive impairment-no dementia (CIND). Eligible participants were drawn from community–dwelling elderly Singaporeans and assessed with an extensive neuropsychological battery and brain MRI. A weighted CeVD burden scale was used to assess small- and large-vessel disease with a score >0 indicating the presence of CeVD. Cognitive composite z-scores were calculated in NCI and CIND groups separately. A total of 256 NCI controls (74 with CeVD) and 568 CIND patients (257 with CeVD) were included in the analysis. Both CIND+CeVD (72.9±6.5 vs. 69.7±6.2, p<0.001) and NCI+CeVD subjects were older (68.9±5.3 vs. 66.2±4.7, p<0.001). NCI+CeVD subjects also had less formal education (57% none or primary level). The presence of CeVD was associated with lower global cognitive score in both NCI (-0.32±1.02 vs. 0.13±0.96, p=0.03) and CIND (-0.23±1.00 vs. 0.23±0.95, p=0.03) groups. For individual domains, NCI+CeVD subjects had lower score in visuomotor speed (-0.39±0.92 vs.0.16±0.99, p=0.003), whilst in CIND group, lower scores on language (-0.23±1.01 vs. 0.24±0.93, p=0.003), visual memory (-0.23±1.03 vs. 0.23±0.92, p=0.01) and visuomotor speed (-0.22±1.01 vs. 0.22±0.94, p=0.002) were found in CeVD patients. All analyses were adjusted for age and education. CeVD was associated with worse cognitive performance among dementia-free subjects including the cognitively intact. The predictive ability of CeVD in cognitive decline warrants further investigation.