Does Brain Age Gap Affect Brain Activation Efficiency in Middle-Aged and Older Adults with Cardiovascular Risks?

Wen-Yih Isaac Tseng, Yung-Chin Hsu, Kit Ying Lew, Pei-Fang Tang, Yu-Chung Chang
Purpose:

This study investigated how BAG affects task-switching-associated brain activation while performing cognitive task-switching in middle-aged and older adults with cardiovascular risks (CVRs), a group prone to faster brain aging and accelerated cognitive declines.

Methods:

This study involved a secondary analysis of data obtained from two clinical trials (ClinicalTrials.gov IDs: NCT03275038 and NCT05672940). The baseline brain MRI data and cognitive performance data of 93 cognitively intact middle-aged and older adults with CVRs from these two trials were examined. The BAG of each participant was estimated using diffusion magnetic resonance imaging (MRI) and a validated model developed by AcroViz Inc. Negative and positive BAG indicated resilient (brain age (BA) chronological age (CA)) and accelerating (BA > CA) brain, respectively. Participant’s brain activity when performing a modified numerical Stroop test (mnST) was measured using blood oxygen level-dependent (BOLD) signals of functional MRI and disjunction analysis, yielding seven regions of interest in bilateral frontal areas, including bilateral superior and middle frontal gyri, left medial superior frontal gyrus, left inferior frontal gyrus pars opercularis, and left supplementary motor area. Performance on the mnST was measured as reaction time and errors. Participants were divided into the negative and positive BAG groups according to their BAG values. The BOLD magnitude was compared between the two groups. Partial correlation analyses were further performed to investigate the relationships between the BOLD magnitude and task-switching performances, controlling for age and education, for each group.

Results:

There were 42 negative (mean age = 63.1 ± 6.8 years; BAG = -5.0 ± 4.3 years) and 51 positive (mean age = 64.1 ± 7.3 years; BAG = 6.0 ± 3.9 years) BAG participants. The two groups had similar demographics and health status, but the negative BAG group showed better control of dyslipidemia (p = 0.011). The positive BAG group exhibited greater overall brain activity during the mnST compared to the negative BAG group (p  0.001) and showed no significant correlations between BOLD magnitude and mnST performance (p > 0.05). By contrast, within the negative BAG group, higher BOLD activity in the left superior frontal gyrus (r = -0.388, p = 0.013) and middle frontal gyrus (r = -0.381, p = 0.015) was associated with fewer errors on the mnST, showing effective brain activation.

Conclusion(s):

This study suggests that maintaining a youthful brain (negative BAG) empowers middle-aged and older adults with CVRs to utilize brain activation more efficiently during cognitive tasks.

Implications:

This study highlights the importance of brain health for preserving the effectiveness of brain activation in aging adults with CVRs. By maintaining brain resilience, successful cognitive aging may be attainable even in aging populations with CVRs.

Funding acknowledgements:
Grants MOST 106-2314-B-002-086-MY3, MOST 109-2314-B-002-116, MOST 110-2314-B-002-062, and MOST 111-2314-B-002-163 from the NSTC, Taiwan, awarded to Dr. Pei-Fang Tang.
Keywords:
brain age gap
functional magnetic resonance imaging
task-switching performance
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Older people
Third topic:
Sustainable health
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Research Ethics Committee of National Taiwan University Hospital
Provide the ethics approval number:
201612213RINB and 201912239RINB
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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