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Cognitive function was assessed using a neuropsychological test battery. A composite CR score was calculated by integrating education, occupational complexity, mental activity, and social support using a structural equation model. A composite ED score was calculated by averaging the z-scores of serum intercellular adhesion molecule-1 (ICAM-1) and vascular cellular adhesion molecule-1 (VCAM-1). Data were analyzed using multiple general linear regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After controlling for multiple potential confounders, higher serum ICAM-1 levels and the composite ED score were significantly associated with lower z-scores in global cognition, verbal fluency, attention, and executive function (p\u2009&lt;\u20090.05), but not with episodic memory z-score (p\u2009&gt;\u20090.05). Higher serum VCAM-1 levels were significantly related with lower z-scores in global cognition, attention, and executive function (p\u2009&lt;\u20090.05), but not with episodic memory or verbal fluency z-score (p\u2009&gt;\u20090.05). There were no statistically significant interactions between ED biomarkers and lifelong CR on cognitive outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vascular ED is associated with worse cognitive performance in dementia-free older adults, independent of lifelong CR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877251385261","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T15:59:06Z","timestamp":1760457546000},"page":"1144-1154","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Associations between endothelial dysfunction, cognitive reserve, and cognitive function in dementia-free older adults: A population-based study"],"prefix":"10.1177","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1628-5753","authenticated-orcid":false,"given":"Yiming","family":"Song","sequence":"first","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjing","family":"Li","sequence":"additional","affiliation":[{"name":"Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute-Stockholm University, Stockholm, Sweden"},{"name":"Department of Physical Activity and Health, The Swedish School of Sport and Health Science, GIH, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiwei","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2268-1249","authenticated-orcid":false,"given":"Jiafeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"},{"name":"Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"},{"name":"Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"},{"name":"Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"},{"name":"Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"},{"name":"Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China"},{"name":"Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute-Stockholm University, Stockholm, Sweden"},{"name":"Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China"},{"name":"Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University &amp; 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