title: Cognitive patterns in relation to biomarkers of cerebrovascular disease and vascular risk factors.
abstract: BACKGROUND
  Risk factors for vascular cognitive impairment (VCI) are the same as traditional risk factors for cerebrovascular disease (CVD). Early identification of subjects at higher risk of VCI is important for the development of effective preventive strategies. In addition to traditional vascular risk factors (VRF), circulating biomarkers have emerged as potential tools for early diagnoses, as they could provide in vivo measures of the underlying pathophysiology. While VRF have been consistently linked to a VCI profile (i.e., deficits in executive functions and processing speed), the cognitive correlates of CVD biomarkers remain unclear. In this population-based study, the aim was to study and compare cognitive patterns in relation to VRF and circulating biomarkers of CVD.
  
  
  METHODS
  The Barcelona-AsIA Neuropsychology Study included 747 subjects older than 50, without a prior history of stroke or coronary disease and with a moderate to high vascular risk (mean age, 66 years; 34.1% women). Three cognitive domains were derived from factoral analysis: visuospatial skills/speed, verbal memory and verbal fluency. Multiple linear regression was used to assess relationships between cognitive performance (multiple domains) and a panel of circulating biomarkers, including indicators of inflammation, C-reactive protein (CRP) and resistin, endothelial dysfunction, asymmetric dimethylarginine (ADMA), thrombosis, plasminogen activator inhibitor 1 (PAI-1), as well as traditional VRF, metabolic syndrome and insulin resistance (homeostatic model assessment for insulin resistance index). Analyses were adjusted for age, gender, years of education and depressive symptoms.
  
  
  RESULTS
  Traditional VRF were related to lower performance in verbal fluency, insulin resistance accounted for lower performance in visuospatial skills/speed and the metabolic syndrome predicted lower performance in both cognitive domains. From the biomarkers of CVD, CRP was negatively related to verbal fluency performance and increasing ADMA levels were associated with lower performance in verbal memory. Resistin and PAI-1 did not relate to cognitive function performance.
  
  
  CONCLUSIONS
  Vascular risk factors, and markers of inflammation and endothelial dysfunction predicted lower performance in several cognitive domains. Specifically, cognitive functions associated with CRP are typically affected in VCI and overlap those related to VRF. ADMA indicated a dissociation in the cognitive profile involving verbal memory. These findings suggest that inflammation and endothelial dysfunction might play a role in the predementia cognitive impairment stages.
authors.affiliation: Departments of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
authors.forename: Júlia
authors.initials: J
authors.lastname: Miralbell
authors.forename: Elena
authors.initials: E
authors.lastname: López-Cancio
authors.forename: Jorge
authors.initials: J
authors.lastname: López-Oloriz
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Arenillas
authors.forename: Maite
authors.initials: M
authors.lastname: Barrios
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Soriano-Raya
authors.forename: Amparo
authors.initials: A
authors.lastname: Galán
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cáceres
authors.forename: Maite
authors.initials: M
authors.lastname: Alzamora
authors.forename: Guillem
authors.initials: G
authors.lastname: Pera
authors.forename: Pere
authors.initials: P
authors.lastname: Toran
authors.forename: Antoni
authors.initials: A
authors.lastname: Dávalos
authors.forename: Maria
authors.initials: M
authors.lastname: Mataró
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002561:Cerebrovascular Disorders / Q000378:metabolism / Q000503:physiopathology* / Q000523:psychology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000378:metabolism / Q000523:psychology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000523:psychology; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008568:Memory / Q000502:physiology*; D024821:Metabolic Syndrome / Q000378:metabolism; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein