Markers of low-grade inflammation and endothelial dysfunction are related to reduced information processing speed and executive functioning in an older population - the Hoorn Study.
Low-grade inflammation and endothelial dysfunction are related to cognitive decline and dementia, in a complex interplay with vascular factors and aging. We investigated, in an older population, low-grade inflammation and endothelial dysfunction in relation to detailed assessment of cognitive functioning. Furthermore, we explored this association within the context of vascular factors. 377 participants (73 ± 6 years) of the population-based Hoorn Study were included. In plasma samples of 2000-2001 (n=363) and/or 2005-2008 (n=323), biomarkers were determined of low-grade inflammation (CRP, TNF-alpha, IL-6, IL-8, SAA, MPO, and sICAM-1) and endothelial dysfunction (vWF, sICAM-1, sVCAM-1, sTM, sE-selectin). In 2005-2008, all participants underwent neuropsychological examination. Composite z-scores were computed for low-grade inflammation and endothelial dysfunction at both time points, and for six domains of cognitive functioning (abstract reasoning, memory, information processing speed, attention and executive functioning, visuoconstruction, and language). The association between low-grade inflammation and endothelial dysfunction, and cognitive functioning was evaluated with linear regression analysis. In secondary analyses, we explored the relation with vascular risk factors and cardiovascular disease. Low-grade inflammation and endothelial dysfunction were associated with worse performance on information processing speed and attention and executive functioning, in prospective and cross-sectional analyses (standardized betas ranging from -0.20 to -0.10). No significant relation with other cognitive domains was observed. Adjusting for vascular factors slightly attenuated the associations. Low-grade inflammation and endothelial dysfunction accounted for only 2.6% explained variance in cognitive functioning, on top of related vascular risk factors and cardiovascular disease. Bootstrapping analyses show that low-grade inflammation and endothelial dysfunction mediate the relation between vascular risk factors and cognitive functioning. This study shows that low-grade inflammation and endothelial dysfunction contribute to reduced information processing speed and executive functioning in an older population.
University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Neurology, Utrecht, The Netherlands. Electronic address: s.m.heringa@umcutrecht.nl.
S M
SM
Heringa
University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Neurology, Utrecht, The Netherlands; Utrecht University, Helmholtz Institute, Department of Experimental Psychology, Utrecht, The Netherlands.
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E
van den Berg
Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Boston, United States.
Y D
YD
Reijmer
VU University Medical Center, Institute for Research in Extramural Medicine (EMGO Institute), Amsterdam, The Netherlands; VU University Medical Center, Department of General Practice, Amsterdam, The Netherlands.
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Nijpels
Maastricht University Medical Centre, Department of Internal Medicine, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
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CD
Stehouwer
Maastricht University Medical Centre, Department of Internal Medicine, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
C G
CG
Schalkwijk
VU University Medical Center, Department of Clinical Chemistry, Amsterdam, The Netherlands.
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T
Teerlink
VU University Medical Center, Department of Clinical Chemistry, Amsterdam, The Netherlands.
P G
PG
Scheffer
Sanquin Blood Supply, Department of Donor Studies, Amsterdam, The Netherlands.
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K
van den Hurk
University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Neurology, Utrecht, The Netherlands.
L J
LJ
Kappelle
VU University Medical Center, Institute for Research in Extramural Medicine (EMGO Institute), Amsterdam, The Netherlands.
J M
JM
Dekker
University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Neurology, Utrecht, The Netherlands.
G J
GJ
Biessels
D000367:Age Factors; D000368:Aged; D000375:Aging / Q000097:blood / Q000523:psychology; D001288:Attention; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D056344:Executive Function; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008606:Mental Processes; D008875:Middle Aged; D009483:Neuropsychological Tests; D013997:Time Factors; D014705:Verbal Behavior
D015415:Biomarkers
Cardiovascular disease; Cognitive functioning; Endothelial dysfunction; Low-grade inflammation; Vascular risk factors