Cardiovascular risk factors and the allostatic interoceptive network in dementia

Abstract Background Cardiovascular risk factors, such diabetes, hypertension, blood pressure, obesity, and smoking, are linked with allostatic‐interoception – the continuous monitoring of internal bodily states in anticipation of environmental demands. These risk factors are associated with dementia risk. How these factors affect brain networks vulnerable to neurodegeneration and involved in allostatic‐interoception, such as the Allostatic‐Interoceptive Network (AIN), is unknown. We investigated the relationship between cardiovascular risk and AIN structure and function in frontotemporal lobar degeneration (FTLD) and Alzheimer's disease (AD). Method We recruited 1501 participants (304 with FTLD, 512 with AD, and 685 healthy controls) from the Multi‐Partner Consortium to Expand Dementia Research in Latin America (ReDLat)(Figure 1). A cardiovascular risk score was calculated based on: age, sex, diabetes, hypertension, systolic blood pressure, body mass index, and smoking status. Cardiovascular risk was associated with gray matter integrity and functional connectivity in age‐ and sex‐matched patient‐control groups focusing on predefined regions of interest within the AIN. Result Higher cardiovascular risk was associated with reduced structural integrity and functional connectivity within the AIN in both FTLD and AD. In FTLD patients, extensive structural (Figure 2) and functional connectivity disruptions (Figure 3) were observed throughout the AIN. In AD patients, structural reductions in the AIN were prominent (Figure 2), with functional connectivity restricted to the hippocampus, parahippocampal gyrus, and orbitofrontal regions (Figure 3). Conclusion Cardiovascular risk factors appear to adversely impact the AIN structure and function, with disease‐specific patterns of vulnerability. Our results underscore the importance of integrating cardiovascular health into models of neurodegenerative disease and managing cardiovascular health to support brain integrity in dementia. Future work is needed to uncover longitudinal effects of cardiovascular risk in dementia and to determine if cardiovascular risk factors exacerbate neurodegenerative processes.

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Publication Details

Journal
Alzheimer s & Dementia
Published
2025-12-01
DOI
https://doi.org/10.1002/alz70856_104821
Primary Topic
Functional Brain Connectivity Studies
Type
article
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article

Cardiovascular risk factors and the allostatic interoceptive network in dementia

Stefanie Danielle Piña‐Escudero, Maria Eugenia Godoy, Elisa de Paula França Resende, Hernando A Santamaría‐García et al.
Alzheimer s & Dementia
Functional Brain Connectivity Studies
article

Cardiovascular risk factors and the allostatic interoceptive network in dementia

Stefanie Danielle Piña‐Escudero, Maria Eugenia Godoy, Elisa de Paula França Resende, Hernando A Santamaría‐García, Jessica L. Hazelton, Pablo Barttfeld, Maira Okada de Oliveira, Marcelo Adrián Maito, Florencia Altschuler, P H M Li, Martín A. Bruno, Cecilia González Campo, Juan Danyster Montoya Cardona, Katherine L. Possin, Carolina González, Kun Hu, Andrea Z. Slachevsky, Joaquin Migeot, Anadina Garcia, Olivia Wen, Ana Luisa Sosa, Hernan Hernandez, José Alberto Ávila Funes, Diana L Matallana, Claudia Duran‐Aniotz, Raul Gonzalez‐Gomez, Pablo A Reyes, Dante Sebastián Galván Rial, Ana Maria Castro Laguardia, Leonel Tadao Takada, Olga Castaner, María Isabel Behrens, Francisco Lopera, Vicente Medel, Nilton Custodio, Jennifer S. Yokoyama, Bruce L. Miller, Agustin Ibanez
article en

Abstract

Abstract Background Cardiovascular risk factors, such diabetes, hypertension, blood pressure, obesity, and smoking, are linked with allostatic‐interoception – the continuous monitoring of internal bodily states in anticipation of environmental demands. These risk factors are associated with dementia risk. How these factors affect brain networks vulnerable to neurodegeneration and involved in allostatic‐interoception, such as the Allostatic‐Interoceptive Network (AIN), is unknown. We investigated the relationship between cardiovascular risk and AIN structure and function in frontotemporal lobar degeneration (FTLD) and Alzheimer's disease (AD). Method We recruited 1501 participants (304 with FTLD, 512 with AD, and 685 healthy controls) from the Multi‐Partner Consortium to Expand Dementia Research in Latin America (ReDLat)(Figure 1). A cardiovascular risk score was calculated based on: age, sex, diabetes, hypertension, systolic blood pressure, body mass index, and smoking status. Cardiovascular risk was associated with gray matter integrity and functional connectivity in age‐ and sex‐matched patient‐control groups focusing on predefined regions of interest within the AIN. Result Higher cardiovascular risk was associated with reduced structural integrity and functional connectivity within the AIN in both FTLD and AD. In FTLD patients, extensive structural (Figure 2) and functional connectivity disruptions (Figure 3) were observed throughout the AIN. In AD patients, structural reductions in the AIN were prominent (Figure 2), with functional connectivity restricted to the hippocampus, parahippocampal gyrus, and orbitofrontal regions (Figure 3). Conclusion Cardiovascular risk factors appear to adversely impact the AIN structure and function, with disease‐specific patterns of vulnerability. Our results underscore the importance of integrating cardiovascular health into models of neurodegenerative disease and managing cardiovascular health to support brain integrity in dementia. Future work is needed to uncover longitudinal effects of cardiovascular risk in dementia and to determine if cardiovascular risk factors exacerbate neurodegenerative processes.

Alzheimer s & DementiaVol. 21(S2)
Universidad de Santiago de Chile (CL), Universidade Federal de Minas Gerais (BR), The University of Sydney (AU), Universidad del Desarrollo (CL), Harvard University (US), Consejo Nacional de Investigaciones Científicas y Técnicas (AR), Universidad Nacional de Córdoba (AR), Universidade de São Paulo (BR), University of California, San Francisco (US), Adolfo Ibáñez University (CL), Pontificia Universidad Javeriana (CO), Universidad de Antioquia (CO), University of San Andrés (AR), Massachusetts General Hospital (US), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX), Hospital del Salvador (CL), University Memory and Aging Center (US), Centro de Recursos Educativos Avanzados (CL), Instituto de Neurología Cognitiva (AR), Universidad Católica de Cuyo (AR), Hospital Del Mar (ES), Hospital Clínico de la Universidad de Chile (CL), Institute of Peruvian Studies (PE), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), Instituto Nacional de Neurología y Neurocirugía (MX), Center for Climate and Resilience Research (CL), Hospital Universitario San Ignacio (CO), National Center for Historical Memory (CO), Global Brain Health Institute (US), University of Chile (CL), Universidad del Valle (CO)
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Functional Brain Connectivity Studies
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