Background: Arterial stiffness (AS) is a key marker of vascular aging and an independent predictor of cardiovascular risk. Although diet has been proposed as an important modifiable factor influencing vascular health, the independent associations between specific macronutrients and minerals and the progression of arterial stiffness remain insufficiently characterized. Objective: The aim of this longitudinal study was to evaluate the independent associations of baseline dietary macronutrient and mineral intake with the 5-year progression of arterial stiffness (assessed via carotid–femoral pulse wave velocity (cfPWV) and cardio-ankle vascular index (CAVI) in adults without prior cardiovascular disease. Methods: This longitudinal study included 466 participants from the EVA study who were evaluated at baseline and after a five-year follow-up (mean age 55.96 ± 14.15 years; 51.1% women). Arterial stiffness was assessed using cfPWV and CAVI. Dietary intake of macronutrients and minerals was estimated using the EVIDENT smartphone application. Multivariable linear regression models were used to examine the association between nutrient intake and arterial stiffness progression. Model 1 was adjusted for age and sex, and Model 2 was additionally adjusted for lifestyle variables and cardiovascular risk factors. Dietary intake was exclusively documented at baseline using a 3-day dietary record, while arterial stiffness parameters (cfPWV and CAVI) were assessed both at baseline and at the five-year follow-up. Results: Higher dietary fiber intake was independently associated with a lower increment in cfPWV after full adjustment (β = −0.025; 95% CI (confidence interval): −0.046 to −0.005). Alcohol intake showed a positive association with CAVI increment in the fully adjusted model (β = 0.020; 95% CI: 0.006 to 0.034). Iron intake was also independently associated with increased CAVI (β = 0.022; 95% CI: 0.004 to 0.041). Carbohydrate intake showed a small positive association with CAVI, whereas no consistent independent associations were observed for other macronutrients or minerals. Conclusions: In this adult population without previous cardiovascular disease, higher dietary fiber intake was associated with lower progression of central arterial stiffness, whereas alcohol and iron intake showed positive associations with peripheral arterial stiffness. Overall, most nutrients were not independently related to arterial stiffness after comprehensive adjustment. These findings suggest that selected dietary components may contribute modestly to vascular aging.

While the Montreal Cognitive Assessment (MoCA) is a reference instrument for cognitive screening, sociodemographic factors such as age and education can affect its diagnostic accuracy. The aims of this systematic review were to characterize the use of the MoCA in samples from Spain and to analyze its psychometric properties. A systematic search was conducted in the main scientific databases up to February 2025. The evidence was synthesized using a dual strategy: a quantitative synthesis (meta-analysis and meta-regression) for the first aim, and a narrative synthesis of psychometric properties guided by the COSMIN framework for the second. Eighty studies were included: 78 ( n = 7,457) in the meta-analysis. The mean MoCA score was 22.85, with substantial heterogeneity ( I ² = 99.3%). Meta-regression explained 62% of this variability, identifying age ( β = −0.19/year) and education ( β = 1.28/year) as the most significant predictors. Scores were lower in dementia and mild cognitive impairment compared with healthy participants. The narrative synthesis of psychometric properties showed that the MoCA has adequate psychometric properties in the studies conducted in Spain, with good internal consistency (Cronbach’s α : 0.76–0.90) and criterion-related validity (area under the curve: 0.78–0.96). The robustness of the findings was confirmed by sensitivity analyses. In conclusion, the MoCA is a valid and widely used tool in Spain, but its performance is strongly modulated by age and education, supporting the use of adjusted normative data rather than a single universal cut-off.

Long COVID is clinically heterogeneous, and reproducible biomarker patterns remain limited. This cross-sectional study aimed to identify clinical-cognitive profiles in 304 patients with long COVID and examine their associations with inflammatory-endothelial biomarkers and intermediate vascular measures. Latent profile analysis was performed using cognitive, subjective memory, fatigue, sleep, pain, affective, frailty, dyspnea, functional and health-related quality-of-life indicators. Associations between retained profiles and biomarkers or vascular variables were examined using linear models adjusted for age, sex, educational level and body mass index. A four-profile solution was retained, comprising a low global burden profile (42.1%), an intermediate affective-mental profile (22.1%), a high multisystem burden profile (17.9%) and an intermediate physical-functional profile (17.9%), with mean posterior probabilities from 0.924 to 0.965. The two intermediate profiles showed a cross-over SF-36 pattern, with lower MCS and relatively preserved PCS in the affective-mental profile and the reverse pattern in the physical-functional profile. Profiles were associated with ICAM-1, F(3,267) = 5.84, BH-adjusted p = .008, partial ηp ² = .065, but not with vascular measures. ICAM-1 remained significant across analyses accounting for classification uncertainty, whereas the endothelin-1 finding was not consistently reproduced. These findings support latent phenotyping as a descriptive strategy for organising long COVID heterogeneity and identify ICAM-1 as the principal hypothesis-generating inflammatory-endothelial correlate of the clinical profiles.

Background: The clinical utility of the Montreal Cognitive Assessment (MoCA) is often limited by normative data derived from linear models, which do not adequately capture non-linear age-related decline and score distribution issues like ceiling effects. This study aimed to generate methodologically rigorous normative data for the Spanish MoCA version 8.1 and its Memory Index Score (MIS) using an advanced regression approach. Methods: A total of 2,034 community-dwelling adults (18–89 years; 56.3% women) were assessed. Bayesian beta generalized additive models (GAMs) were used to model the effects of age, sex, and education. Normative data were generated as percentiles from the model’s standardized residuals. To facilitate direct clinical application, a user-friendly automated calculator was also developed. Results: Non-linear GAMs demonstrated superior fit and predictive accuracy versus linear models, multiple fractional polynomial (MFP) models, and generalized additive models for location, scale, and shape (GAMLSS). Gains over GAMLSS were small but consistent, and model diagnostics supported the stability of the final solutions. The final models explained a significant amount of variance (Bayesian R² ≈ 0.43 for the MoCA; ≈ 0.26 for the MIS). Age (with a marked nonlinear effect) and education were associated with both outcomes, whereas sex-related effects differed between the MoCA and MIS models. Conclusions: This study provides updated and rigorous normative data for the Spanish MoCA 8.1 and MIS. By accurately modelling demographic effects, the proposed norms and accompanying calculator may support more precise normative interpretation in Spanish adults; however, external clinimetric validation is required before advocating diagnostic use or broad generalization.

Background: The Montreal Cognitive Assessment (MoCA) is widely used for cognitive screening, but its dimensionality and domain-specific accuracy require validation with methods for ordinal items. The objective was to analyze the internal structure of the MoCA in a cognitive impairment-free Spanish community sample and examine its relationship with variables potentially related to the risk of cognitive impairment. Method: A total of 1,767 Spanish adults (aged 18-89 years) were assessed in primary care centers using the MoCA, and sociodemographic and health variables were recorded. Internal structure and metric properties were analyzed using factor models and item response theory, as well as their association with external variables and the concordance of the resulting solution. Results: The theoretical models tested did not demonstrate adequate fit. Cross-validation identified a 12-item solution in two correlated factors (Memory and Multiple), with excellent fit (CFI = .991; RMSEA = .019) and latent correlation r = .63. The abbreviated version showed high concordance with the total score (ICC = .96) and substantial agreement in dichotomous classification (k = .84). Conclusions: The MoCA exhibited a two-factor structure and consistent associations with external variables such as age, educational level, and vascular risk; a dimensional interpretation is recommended.

Background: Long COVID (LC) has been associated with persistent inflammation and endothelial dysfunction. Dietary components, particularly vitamins, are involved in inflammation, oxidative stress, and vascular homeostasis, and may influence arterial stiffness in this population. However, the relationship between dietary vitamin intake and vascular stiffness parameters in patients with LC remains poorly understood. Objective: To analyze the association between dietary vitamin intake and central and peripheral arterial stiffness, evaluated by carotid–femoral pulse wave velocity (cfPWV) and brachial–ankle pulse wave velocity (baPWV), in patients with LC. Methods: We conducted a cross-sectional study that included 304 patients with LC. Dietary vitamin intake was assessed using a validated 7-day dietary record (EVIDENT tool). Vascular assessment included cfPWV and baPWV, measured using validated devices (SphygmoCor^® and VaSera^®). Multiple linear regression analyses were performed to evaluate the associations between vitamin intake and vascular parameters. Model 1 was adjusted for age and sex, while Model 2 additionally included the number of metabolic syndrome components, the SF-36 general health domain, and adherence to the Mediterranean diet. Correction for multiple comparisons was performed using the Benjamini–Hochberg procedure across 36 vitamin–outcome–model contrasts. Results: The mean age was 52.78 ± 11.91 years, and 207 participants were women (68.1%); men were older than women (p = 0.004). In multiple regression analysis, inverse estimates for vitamin B1 intake with cfPWV were observed in both Model 1 (β = −0.568; 95% CI: −1.016 to −0.119; p = 0.014) and Model 2 (β = −0.491; 95% CI: −0.923 to −0.059; p = 0.027). Vitamin B6 intake showed a similar pattern with cfPWV in Model 1 (β = −0.312; 95% CI: −0.606 to −0.018; p = 0.039) and Model 2 (β = −0.302; 95% CI: −0.586 to −0.018; p = 0.038). Vitamin B2 showed inverse but non-significant associations with cfPWV. No significant associations were observed between vitamin intake and baPWV. After FDR correction, no vitamin-arterial stiffness association remained statistically significant; the FDR-adjusted q-value for the B1/B6-cfPWV estimates was 0.347. Conclusions: In this exploratory cross-sectional study, habitual food-based vitamin intake was not significantly associated with central or peripheral arterial stiffness after correction for multiple comparisons. Vitamins B1 and B6 showed inverse nominal estimates with cfPWV; however, these estimates did not survive FDR correction and were not reproduced for baPWV. Longitudinal studies incorporating biochemical micronutrient markers, medication and supplementation data, inflammatory and homocysteine-related biomarkers, and repeated vascular assessment are needed to clarify whether vitamin status is related to vascular health among individuals with persistent post-COVID-19 symptoms.