P277 - THE RELATIONSHIP BETWEEN CARDIORESPIRATORY FITNESS AND COGNITION IN WITH CARDIOVASCULAR RISK FACTORS, CORONARY DISEASE AND HEART FAILURE

Background: Cardiorespiratory fitness (V̇O₂max) is a modifiable factor associated with cognitive health. However, the mechanisms linking V̇O₂max and its parameters to cognition remain unclear across cardiovascular disease (CVD) stages, especially in women. Clarifying these associations could provide insights into how cardiorespiratory and brain health interact in women. We aim to compare the associations between V̇O₂max and its physiological parameters with cognitive performance in women aged 50 and older across CV risk and diseases stages. We hypothesized that these associations would vary according to disease severity.

METHODS AND RESULTS: A total of 149 women were recruited: 18 (66.8 years, V̇O₂max:19.6 ml/min/kg) with low cardiovascular risk (Framingham < 10%), 88 (70.4 years, V̇O₂max:18.5 ml/min/kg) with moderate risk (Framingham 10–19%)[1], 10 (64.6 years, V̇O₂max:18.5 ml/min/kg) with coronary artery disease (CAD), and 33 (66.2 years, V̇O₂max:12.8 ml/min/kg) with heart failure (HF). All participants completed a maximal cardiopulmonary exercise test assessing V̇O₂max and key parameters: oxygen uptake efficiency slope (OUES), minute ventilation/carbon dioxide slope (V̇E/V̇CO₂), and 1-minute heart rate recovery (HRR). Cognition was assessed using the Montreal Cognitive Assessment (MoCA) for global cognition, the Rey Auditory Verbal Learning Test (RAVLT) for episodic memory, phonemic fluency (letter P), Trail Making Test A and B (TMT), Stroop test, and the Digit Symbol Substitution Test (DSST) for executive functions and processing speed. Partial correlations were performed among each CVD group between V ̇O2max (and its parameters) and cognitive scores, controlling for age and education.

In the low-risk group, V̇O₂max was associated with the RAVLT total learning (r=.527, p =.043), Stroop reading (r=-.602, p=0.018), inhibition (r=-.542, p=0.037), switching (r=-.562, p=0.029), and DSST (r=.851, p=0 < 001). The V̇E/V̇CO₂ slope was linked to Stroop reading (r=.573, p=0.025), and HRR to RAVLT Trial 1 (r=.542, p=0.037). OUES was associated with DSST (r=.588, p=0.021). In the moderate-risk group, HRR showed associations with DSST (r=.347, p=0.006) and Stroop switching (r=-.381, p=0.002).
Among women with CAD, the V̇E/V̇CO₂ slope was associated with the RAVLT total learning (r=-.721, p=0.043) and the delayed recall (r=-.715, p=0.046).
In the HF group, the V̇E/V̇CO₂ slope was related to RAVLT Trial 1 (r=-.521, p=0.015) and total learning (r=-.480, p=0.028).

Conclusion: V̇O₂max and its parameters show distinct patterns of associations with cognitive functions depending on disease severity. V̇O₂max was most strongly associated with cognition in low-risk women, whereas HRR was more relevant in those with moderate risk. In contrast, V̇E/V̇CO₂ showed the most associations in women with CAD or HF, primarily with episodic memory.