title: The adverse effects of reduced cerebral perfusion on cognition and brain structure in older adults with cardiovascular disease.
abstract: BACKGROUND
  It is well established that aging and vascular processes interact to disrupt cerebral hemodynamics in older adults. However, the independent effects of cerebral perfusion on neurocognitive function among older adults remain poorly understood. We examined the associations among cerebral perfusion, cognitive function, and brain structure in older adults with varying degrees of vascular disease using perfusion magnetic resonance imaging (MRI) arterial spin labeling (ASL).
  
  
  METHODS
  52 older adults underwent neuroimaging and were administered the Mini Mental State Examination (MMSE), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and measures of attention/executive function. ASL and T1-weighted MRI were used to quantify total brain perfusion, total brain volume (TBV), and cortical thickness.
  
  
  RESULTS
  Regression analyses showed reduced total brain perfusion was associated with poorer performance on the MMSE, RBANS total index, immediate and delayed memory composites, and Trail Making Test B. Reduced frontal lobe perfusion was associated with worse executive and memory function. A similar pattern emerged between temporal lobe perfusion and immediate memory. Regression analyses revealed that decreased total brain perfusion was associated with smaller TBV and mean cortical thickness. Regional effects of reduced total cerebral perfusion were found on temporal and parietal lobe volumes and frontal and temporal cortical thickness.
  
  
  CONCLUSIONS
  Reduced cerebral perfusion is independently associated with poorer cognition, smaller TBV, and reduced cortical thickness in older adults.
  
  
  CONCLUSIONS
  Prospective studies are needed to clarify patterns of cognitive decline and brain atrophy associated with cerebral hypoperfusion.
authors.affiliation: Department of Psychology, Kent State University Kent, Ohio.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.affiliation: Department of Psychology, Kent State University Kent, Ohio.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence, Rhode Island.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Jerskey
authors.affiliation: Department of Psychology, Idaho State University Pocatello, Idaho.
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Neurology, Icahn School of Medicine at Mount Sinai New York, NY.
authors.forename: Uraina S
authors.initials: US
authors.lastname: Clark
authors.affiliation: Department of Neurology, Washington University at St. Louis St. Louis, Missouri.
authors.forename: Jason
authors.initials: J
authors.lastname: Hassenstab
authors.affiliation: Butler Hospital Providence, Rhode Island.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Cote
authors.affiliation: Department of Neuroscience, Brown University Providence, Rhode Island.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Walsh
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence, Rhode Island.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Labbe
authors.affiliation: Department of Physiology, Université de Montréal Montréal, Quebec, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Hoge
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence, Rhode Island ; Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida Gainesville, Florida.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence, Rhode Island ; Butler Hospital Providence, Rhode Island ; Department of Psychology, University of Georgia Athens, Georgia.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
keywords: Arterial spin labeling; cardiovascular disease; cerebral blood flow; cerebrovascular disease; cognitive function; magnetic resonance imaging; neuroimaging