title: Ankle-Brachial Index but Neither Intima Media Thickness Nor Coronary Artery Calcification is Associated With Mild Cognitive Impairment.
abstract: BACKGROUND
  Several studies have reported an association of atherosclerosis with mild cognitive impairment (MCI) and dementia independent of cardiovascular risk factors.
  
  
  OBJECTIVE
  To compare the cross-sectional association of the ankle-brachial index (ABI), intima media thickness (IMT), and coronary artery calcification (CAC) with MCI and its subtypes, amnestic MCI (aMCI) and non-amnestic MCI (naMCI) in the population-based Heinz Nixdorf Recall cohort study.
  
  
  METHODS
  4,086 participants performed a validated brief cognitive assessment at the first follow-up examination (2006-2008). MCI was diagnosed according to previously published criteria. Prevalence ratio (PR) regression models adjusted for age, gender, education, cardiovascular risk factors, and APOE genotype were used to compare the association of the ABI, the CAC-Agatston score and the IMT with MCI and its subtypes.
  
  
  RESULTS
  We identified 490 participants with MCI (mean age 66.1 ± 7.8, 46.9 % male, aMCI n = 249, naMCI n = 241) and 1,242 cognitively normal participants. A decreasing ABI (per 0.1) was significantly associated with a higher MCI prevalence in fully adjusted models (PR 1.06; 95% confidence interval (CI) 1.01-1.11), whereas an increasing CAC (log(CAC+1)) or IMT (per 0.1 mm) were not associated after adjustment. A decreasing ABI was also significantly associated with naMCI in fully adjusted models (PR 1.12; CI 1.03-1.21) but not with aMCI.
  
  
  CONCLUSIONS
  Our data show that the degree of generalized atherosclerosis as measured by the ABI is associated with MCI and with naMCI in a population-based cohort.
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Weimar
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Winkler
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany.
authors.forename: Martha
authors.initials: M
authors.lastname: Dlugaj
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Lehmann
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine.
authors.forename: Frauke
authors.initials: F
authors.lastname: Hennig
authors.affiliation: Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Bauer
authors.affiliation: Department of Angiology, Helios Kliniken Krefeld, Germany.
authors.forename: Knut
authors.initials: K
authors.lastname: Kröger
authors.affiliation: Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Hagen
authors.initials: H
authors.lastname: Kälsch
authors.affiliation: Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Amir-Abass
authors.initials: AA
authors.lastname: Mahabadi
authors.affiliation: Institute for Medical Sociology, Centre for Healthy and Society, Medical Faculty, University of Düsseldorf, Germany.
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine.|Medical Faculty, Deanery of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.affiliation: Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000368:Aged; D000647:Amnesia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D055109:Ankle Brachial Index; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011581:Psychological Tests; D011859:Radiography
keywords: Aging; ankle-brachial index; atherosclerosis; cognition; coronary artery calcification; intima media thickness; mild cognitive impairment; peripheral arterial disease; population-based studies