Vascular predictors of cognitive decline in patients with mild cognitive impairment.
Our aim in this study was to assess the relationship between the state of cerebral vessels and the risk of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). We included 117 MCI patients. They underwent an ultrasonographic assessment of common carotid arteries intima-media thickness (IMT) and carotid plaque index. Cerebrovascular reactivity to hypercapnia in the middle cerebral arteries was calculated with the Breath-Holding Index (BHI). After a 12-month follow-up period, neuropsychological examinations demonstrated a progression to dementia in 21 patients. Pathological values of BHI and IMT significantly increased the risk of conversion (BHI: odds ratio, 5.80; 95% confidence interval, 1.83-18.37, p < 0.05; IMT: odds ratio, 3.08; 95% confidence interval, 1.02-9.33; p < 0.05, multinomial logistic regression analysis). Comparison between patients with all normal values and those with the simultaneous alteration of the 2 vascular indexes showed an increase in the risk of conversion from 9% to 33% (ordinal regression analysis). Our findings show that alterations of cerebral vessel functional and anatomic status increase the risk of conversion from MCI to dementia.
Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
Giovanna
G
Viticchi
Lorenzo
L
Falsetti
Fabrizio
F
Vernieri
Claudia
C
Altamura
Marco
M
Bartolini
Simona
S
Luzzi
Leandro
L
Provinciali
Mauro
M
Silvestrini
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D059168:Carotid Intima-Media Thickness / Q000639:trends; D003072:Cognition Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests