Association between life's essential 8 and changes of brain structural features: A population-based prospective cohort study

BACKGROUND: Worse lifestyle behaviors and metabolic indicators may contribute to the deterioration of brain health during long period of follow-up. However, evidence from large populations remains insufficient. METHODS: A total of 3736 participants with two magnetic resonance imaging (MRI) scan from the UK Biobank were included. The Life's Essential 8 (LE8) score was calculated according to the lifestyle behaviors and metabolic indicators. Brain structural features are divided into two dimensions of rate and direction. Generalized linear models were used to estimate the association between the LE8 score and the rate of changes in brain MRI features. Multiple logistic regression models were implemented to analyze the association between the LE8 score and the directional changes in neuroimaging features. RESULTS: Subjects exhibiting a lower LE8 score were associated with rapid changes in structural features, including brain volume, cortical thickness, and surface areas in sub-regions of the brain. The presence of white matter lesions were also significant in subjects with lower LE8 score in deep regions of the brain (β=99.520; 95% CI: 44.307-154.733) and periventricular regions (β=129.161; 95% CI: 45.982-212.341). Specifically, these subjects were featured by a reduction in the left total surface area (OR: 1.324; 95% CI: 1.078-1.626), increased cortical thickness in left lateral occipital cortex (OR: 0.787; 95% CI: 0.641-0.966) and decreased FA and MD values in multiple brain subregions. CONCLUSIONS: These findings suggested the importance of maintaining better lifestyle behaviors and metabolic indicators for promoting optimal brain health.