title: Cardiac hemodynamics are linked with structural and functional features of brain aging: the age, gene/environment susceptibility (AGES)-Reykjavik Study.
abstract: BACKGROUND
  Advanced heart failure is linked with structural and functional alterations in the brain. It is unclear whether a graded decrease in cardiac function puts older subjects at risk for brain aging. We investigated the association between cardiac hemodynamics and features of brain aging in community-dwelling older subjects.
  
  
  RESULTS
  With data from a sub-study (n=931 subjects, mean age 75.9 years, 47.7% male) of the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we investigated the association of MRI measures of cardiac hemodynamics, including left ventricular stroke volume (LVSV) and cardiac output (CO) to brain characteristics. In multivariable analyses, each 10 mL lower LVSV was associated with 4.4 mL (95% CI 1.9 to 6.9) lower total parenchymal brain volume (TBV) and 3.7 mL (95% CI 1.8 to 5.7) lower gray matter volume (GMV). Likewise, each unit (L/min) lower CO was associated with 3.9 mL (95% CI 0.4 to 7.4) lower TBV and 3.9 mL (95% CI 0.4 to 7.4) lower GMV. Lower LVSV was associated with worse performance in processing speed (P=0.043) and executive function (P<0.001). Lower CO was associated with worse performance in processing speed (P=0.015) and executive function (P=0.003). Each 10 mL lower LVSV and each unit lower CO associated with a higher risk of mild cognitive impairment or dementia (odds ratio: 1.24, 95% CI 0.99 to 1.57 and odds ratio: 1.40, 95% CI 0.99 to 2.00, respectively).
  
  
  CONCLUSIONS
  A graded decrease in cardiac functioning is associated with features of brain aging. Older persons with cardiac or cognitive signs and symptoms may have both cardiac and cerebral diseases and should be evaluated accordingly.
authors: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands (B.S., M.A.B.).
authors: Behnam
authors: B
authors: Sabayan
authors: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands (B.S., M.A.B.).
authors: Mark A
authors: MA
authors: van Buchem
authors: Icelandic Heart Association, Reykjavik, Iceland (S.S., V.G.).
authors: Sigurdur
authors: S
authors: Sigurdsson
authors: Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (Q.Z., T.B.H., L.J.L.).
authors: Qian
authors: Q
authors: Zhang
authors: Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (Q.Z., T.B.H., L.J.L.).
authors: Tamara B
authors: TB
authors: Harris
authors: Icelandic Heart Association, Reykjavik, Iceland (S.S., V.G.).
authors: Vilmundur
authors: V
authors: Gudnason
authors: Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (A.E.A.).
authors: Andrew E
authors: AE
authors: Arai
authors: Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (Q.Z., T.B.H., L.J.L.).
authors: Lenore J
authors: LJ
authors: Launer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology*; D002303:Cardiac Output, Low / Q000175:diagnosis / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology*; D006334:Heart Function Tests; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007055:Iceland; D057187:Independent Living; D016014:Linear Models; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D018570:Risk Assessment; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology
keywords: brain aging; cardiac output; cognitive impairment; stroke volume
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