# Precursors of Stroke Incidence and Prognosis

> **NIH NIH R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $1,401,859

## Abstract

PROJECT SUMMARY/ABSTRACT
Post-stroke cognitive impairment and dementia (PS-VCID) are major contributors to Alzheimer’s disease and
related dementias (ADRD), occurring in 30% of stroke survivors. An individual’s complex life-course exposure
to vascular risk factors, along with the varying prevalence and incidence of cardiovascular risk factors among
the U.S. population, make study of the link between life-course exposure to cardiovascular risk factors and ADRD
a priority. Furthermore, the ability to accurately estimate an individual’s risk for PS-VCID at a particular timepoint
in life, even before a stroke occurs, is critical for planning personalized and public health interventions to improve
brain health and resilience. Risk factors such as obesity and dyslipidemia have gained epidemic proportions in
the U.S., but their causal role and contribution to PS-VCID risk are undefined. Further, PS-VCID risk prediction
tools using multimodal data and in multiple racial groups are not available. This proposal seeks to leverage FHS
data and resources to generate an understanding of PS-VCID trends and determinants, to collaborate with
REGARDS and ARIC study investigators to develop and validate in bi-racial participants comprehensive PS-
VCID risk prediction tools (including incorporation of a measure of social determinant of health), to study the
causal relations of obesity and dyslipidemia with PS-VCID, to explore repurposing of available drug treatments,
and to inform prevention strategies and treatment targets for PS-VCID. Specific Aims include: Aim 1, to describe
trends in PS-VCID risk in community dwelling individuals; Aim 2, to evaluate the life-course correlates of PS-
VCID using novel machine learning methods to exame the relation of repeated exposure measures, assessed
prospectively over seven decades, with PS-VCID, including i) Framingham Stroke Risk Profile components, ii)
lipid fractions, iii) obesity indicators, iv) hypertension types, and v) multi-organ disease; Aim 3, to develop two
PS-VCID risk prediction tools (PS-VCID risk scores) for i) clinical risk assessment (based on cardiovascular risk
factors, obesity measures, and dyslipidemia) and ii) use in research (with addition of brain imaging-derived
factors quantifying global cerebral small vessel disease burden, global gray matter volume and cortical thickness,
social factors (Area deprivation index) and genetic factors based on identification of the optimal polygenic risk
score for each vascular risk factor). Scores will be developed in the well-characterized FHS and REGARDS
cohorts, and then assessed and validated in the ARIC study. Aim 4, to study the causal relation of obesity and
dyslipidemia with PS-VCID and explore drug repurposing strategies in an instrumental variable analyses
framework.

## Key facts

- **NIH application ID:** 10925284
- **Project number:** 5R01NS017950-39
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Hugo Javier Aparicio
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,401,859
- **Award type:** 5
- **Project period:** 1981-12-01 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10925284

## Citation

> US National Institutes of Health, RePORTER application 10925284, Precursors of Stroke Incidence and Prognosis (5R01NS017950-39). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10925284. Licensed CC0.

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