title: Vascular and cognitive functions associated with cardiovascular disease in the elderly.
abstract: 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.
authors.affiliation: Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA. RCohen@lifespan.org
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
authors.forename: Athena
authors.initials: A
authors.lastname: Poppas
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Forman
authors.forename: Karin F
authors.initials: KF
authors.lastname: Hoth
authors.forename: Andreana P
authors.initials: AP
authors.lastname: Haley
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
authors.forename: Angela L
authors.initials: AL
authors.lastname: Jefferson
authors.forename: David F
authors.initials: DF
authors.lastname: Tate
authors.forename: Robert H
authors.initials: RH
authors.lastname: Paul
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
authors.forename: Mokato
authors.initials: M
authors.lastname: Ono
authors.forename: Beth A
authors.initials: BA
authors.lastname: Jerskey
authors.forename: Marie
authors.initials: M
authors.lastname: Gerhard-Herman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000150:complications* / Q000473:pathology / Q000523:psychology*; D003072:Cognition Disorders / Q000150:complications* / Q000473:pathology / Q000523:psychology; D004452:Echocardiography / Q000379:methods; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016013:Likelihood Functions; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009483:Neuropsychological Tests; D025341:Principal Component Analysis