title: Vascular Health Indices and Cognitive Domain Function: Singapore Longitudinal Ageing Studies.
abstract: BACKGROUND
  Few studies have comprehensively evaluated the relationship between vascular disease and cognition of older adults without cardiac disease.
  
  
  OBJECTIVE
  We explored the associations of structural atherosclerosis, vascular stiffness, and reactivity with global, memory, attention, language, visuospatial ability, and executive function in community-dwelling, non-demented older Asians without cardiac diseases.
  
  
  METHODS
  Cognition was assessed by Mini-Mental State Examination (MMSE) (n = 308) and detailed neuropsychological tests (n = 155). Vascular measures included carotid intima-media thickness; aortic stiffness [carotid-femoral pulse wave velocity (CFPWV), aortic augmentation index (AI), and aortic pulse pressure (PP)]; carotid stiffness [elasticity modulus (Ep), beta index (β), arterial compliance (AC), carotid AI]; and endothelial function [reactive hyperemia index (RHI)]. Multivariable analyses controlled for potential confounding by demographics, apolipoprotein E genotype and cardiovascular risk factors.
  
  
  RESULTS
  The participants' mean age was 63.0 ± 6.1 years. Inverse associations with MMSE were found for AC (β= 0.128, p = 0.019), Ep (β= -0.151, p = 0.008), β index (β= -0.122, p = 0.029), carotid stiffness z-score (β= -0.154, p = 0.007); with executive function for CFPWV (β= -0.209, p = 0.026), AC (β= 0.214, p = 0.005), Ep (β= -0.160, p = 0.050), β index (β= -0.165, p = 0.041), and both aortic (β= -0.229, p = 0.010) and carotid (β= -0.208, p = 0.010) stiffness z-scores; with verbal memory for AI (β= -0.229, p = 0.004) and aortic (β= -0.263, p = 0.004) stiffness z-score; with language for AI (β= -0.155, p = 0.025), aortic stiffness z-score (β= -0.196, p = 0.011). RHI positively correlated with visuospatial ability (β= 0.195, p = 0.013) and executive function (β= 0.151, p = 0.045).
  
  
  CONCLUSIONS
  The results support a link between systemic vascular health and neurocognitive function in older Asian adults. Subclinical noninvasive measures of arterial stiffness and reactivity may identify individuals vulnerable to cognitive impairment.
authors.affiliation: Department of Cardiology, National University Heart Center, Singapore.
authors.forename: Shir Lynn
authors.initials: SL
authors.lastname: Lim
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Qi
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Ma Shwe Zin
authors.initials: MS
authors.lastname: Nyunt
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Lingli
authors.initials: L
authors.lastname: Gong
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Josephine B
authors.initials: JB
authors.lastname: Lunaria
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: May Li
authors.initials: ML
authors.lastname: Lim
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Audrey
authors.initials: A
authors.lastname: Ling
authors.affiliation: Department of Cardiology, National University Heart Center, Singapore.|Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Department of Cardiology, National Heart Center, Singapore.|Cardiovascular and Metabolic Disorders Program, Duke-NUS Graduate Medical School Singapore, Singapore.
authors.forename: Carolyn Su-Ping
authors.initials: CS
authors.lastname: Lam
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Cardiovascular Research Institute, National University Health System, Singapore.|Christchurch Heart Institute, University of Otago, New Zealand.
authors.forename: Arthur Mark
authors.initials: AM
authors.lastname: Richards
authors.affiliation: Department of Cardiology, National University Heart Center, Singapore.|Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Lieng Hsi
authors.initials: LH
authors.lastname: Ling
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tze Pin
authors.initials: TP
authors.lastname: Ng
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D000066492:Cognitive Aging / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D012846:Singapore / Q000453:epidemiology; D059289:Vascular Stiffness / Q000502:physiology*
keywords: Arterial stiffness; carotid intima-media thickness; cognition; endothelial function