Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Coronary artery disease (CAD) has been linked with poorer cognitive function, potentially through shared risk factors and vascular pathways linking atherosclerotic disease to cerebral vascular injury. However, the association between CAD and neurocognitive performance remains poorly characterized in African populations. Methods We analyzed data from the Uganda Aging and Dementia Cohort Study among participants with coronary computed tomography imaging and neurocognitive testing data. The primary exposure was imaging-defined CAD, and cognitive performance was evaluated at the global-composite, domain-composite, and individual-test levels. Multivariable linear regression models adjusted for age, sex, and HIV status. HIV-stratified models adjusted for age and sex, and CAD-by-HIV interaction terms assessed effect modification. We examined predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk > 5% as an alternative cardiovascular-risk exposure. Higher b coefficients indicated poorer performance. Benjamini-Hochberg false-discovery-rate (FDR) correction was applied within outcome tiers. Results Among 512 participants, mean age was 57.9 years (SD, 6.3), 252 (49.2%) were female, 238 (46.5%) were people with HIV (PWH), 42 (8.2%) had CAD, and 203 (39.6%) had ASCVD risk > 5%. CAD was not associated with global cognition (b = 0.093 SD units; 95% CI, − 0.122 to 0.308; P = 0.397). At individual-test level, CAD was associated with poorer performance on Color Trails 2 (a measure of executive function) (b = 0.502; 95% CI, 0.184 to 0.821; P = 0.002; q = 0.026) and nominally associated with poorer performance on Digits Forward (a measure of attention and immediate verbal span) (b = 0.386; 95% CI, 0.028 to 0.744; P = 0.035; q = 0.210). In HIV-stratified analyses, CAD was nominally associated with poorer Digits Forward performance among PWOH (b = 0.552; P = 0.006; q = 0.070) and poorer Color Trails 2 performance among PWH (b = 0.646; P = 0.010; q = 0.121), but neither survived FDR correction and interaction tests did not support effect modification. ASCVD risk > 5% was nominally associated with poorer learning-and-memory domain performance (b = 0.188; 95% CI, 0.026 to 0.350; P = 0.023; q = 0.116) and poorer WHO/UCLA AVLT total recall (b = 0.231; 95% CI, 0.048 to 0.414; P = 0.014; q = 0.162); neither survived FDR correction. Conclusion CAD was not associated with global or domain-level neurocognitive performance. Its association with poorer Color Trails 2 performance may suggest selective vulnerability in executive control, but requires confirmation in larger longitudinal studies.
Source: Research Square
Authors: Richard Migisha, Jolina Lombardi, Pauline Byakika-Kibwika, Noeline Nakasujja, Samuel Maling, Peter Kangwagye, Abraham Muhwezi, Christopher T. Longenecker, Samson Okello, Moses Acan, Flavia Atwiine, Edna Tindimwebwa, Zahra Reynolds, Robert Paul, Brian Ghoshhajra, Eliza Passell, Deanna Saylor, Miria Kyokusiima, Geoffrey Erem, Alexander C. Tsai, Jeremy A. Tanner, Stephen Asiimwe, Mark J. Siedner
Institutions: Mbarara University of Science and Technology, University of California, San Francisco, Makerere University, University of Washington, University of North Carolina at Chapel Hill, Massachusetts General Hospital, University of Missouri–St. Louis, The University of Texas at San Antonio Health Science Center
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Epidemiology of coronary artery disease among people with HIV in rural sub-Saharan Africa, Quality of Life and Aging with HIV in Rural Uganda, Aging and Dementia Research and Training (ADRET) Program in Uganda, Bridging Gaps to Translate Plasma Alzheimer's Disease Biomarkers to Diverse Populations, Mentoring patient-oriented research to improve cardiovascular health among people with HIV in sub-Saharan Africa
OpenAlex ID: W7212132814