Estimating the treatment effect of cardiovascular medications to modify the risk for future cognitive decline in older adults

Project Summary/Abstract Candidate: I aspire to become an independent clinician-investigator working at the intersection of cardiovascular disease and aging, focused on the impact of cardiovascular treatments on cognition, function, and global quality of life in older adults. My clinical expertise as an interventional cardiologist combined with my

research training through my Master’s in Health Sciences and Clinical Research have positioned me to accomplish this goal. I have a track record of success and independent funding for my aging research through a GEMSSTAR award, two Pepper Center grants, and a PCORI Healthy Aging award. Mentors and Environment: This project will be supported by a world-class mentorship team, including Dr.

Thomas Gill (Geriatrics), a global leader in randomized trials in older adults and Director of the Yale Program on Aging (PoA) and Claude D. Pepper Older Americans Independence Center (OAIC), as well as co-mentors Dr. Eric Velazquez (Cardiology), an internationally recognized cardiovascular trialist and Chief of the Yale Heart

& Vascular Center, and Dr. Jeff Williamson (Geriatrics, Alzheimer’s Disease and Related Dementias (ADRD)), an expert in brain health and physical function in older adults and PI of the SPRINT MIND and PREVENTABLE trials. My advisory team includes experts in biostatistics, analytical sciences, randomized trial design, the study

of ADRD and the heart-brain continuum. We have constructed a comprehensive career development plan that will leverage the infrastructure of the Yale PoA/OAIC, the Yale Alzheimer’s Disease Research Center (ADRC), the Duke-UNC ADRC, national educational resources for ADRD-related research, and leadership training. The

combined support of the Yale School of Medicine PoA/OAIC, ADRC, and sections of Geriatrics & Cardiology, and my external collaborators, will catalyze my successful career development and completion of the proposed research plan. Mentored Research Project: Older adults with cardiovascular disease frequently cite maintenance of

cognitive function as their top health priority. Recent randomized trials have begun to investigate whether commonly used cardiovascular treatments can modify the risk of developing cognitive impairment or dementia. Stable ischemic heart disease is one of the most commonly treated conditions impacting older adults, with

beta-blockers & calcium channel blockers considered the two first-line anti-anginal treatments. To date, these agents have not been adequately tested in older populations and their long-term effect on cognitive outcomes is unknown. We will leverage existing longitudinal data from the SPRINT MIND trial as well as

prospective randomized trial data from the PCORI-sponsored LIVEBETTER trial to rigorously evaluate the effect of these two commonly used medication classes on cognitive status over time, mild cognitive impairment, and the incidence of dementia among older adults.