Vascular and cognitive functions associated with cardiovascular disease in the elderly.

Cohen RA, Poppas A, Forman DE, Hoth KF, Haley AP, Gunstad J, Jefferson AL, Tate DF, Paul RH, Sweet LH, Ono M, Jerskey BA, Gerhard-Herman M
J Clin Exp Neuropsychol. 2009 31 (1): 96-110

PMID: 18608677 · PMCID: PMC2739675 · DOI:10.1080/13803390802014594

This study examines the relationship between systemic vascular function, neurocognitive performance, and structural brain abnormalities on magnetic resonance imaging (MRI) among geriatric outpatients with treated, stable cardiovascular disease and no history of neurological illness (n = 88, ages 56-85 years). Vascular function was assessed by cardiac ejection fraction and output, sequential systolic and diastolic blood pressures, flow mediated brachial artery reactivity (BAR), and carotid intima media thickness (IMT). White matter hyperintensities (WMH) on MRI were quantified and examined relative to cognitive and vascular function. Principal component analysis revealed two primary vascular components: one associated with cardiac function, the other with atherosclerotic burden/endothelial dysfunction. Both factors were significantly associated with cognitive function and WMH volume. Reduced systolic variability and increased IMT were most strongly related to reduced attention, executive function, and information-processing speed. These findings suggest the possibility that systemic vascular indices may provide proxy measures of cerebrovascular dysfunction and reinforce the importance of achieving greater understanding of interaction between systemic vascular disease and brain dysfunction among elderly people with cardiovascular disease.

MeSH Terms (18)

Aged Aged, 80 and over Blood Pressure Brain Cardiovascular Diseases Cognition Disorders Echocardiography Female Geriatric Assessment Humans Likelihood Functions Magnetic Resonance Imaging Male Mental Processes Middle Aged Myocardium Neuropsychological Tests Principal Component Analysis

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