A low ankle-brachial index is associated with cognitive impairment: The APAC study.
Given the recognized links between atherosclerosis and cognitive impairment, the aim of this study was to examine the association between the ankle-brachial index (ABI) and cognitive impairment in a cross-sectional setting of a Chinese population.



Participants (n = 3,048, aged ≥40 years, 1727 men and 1321 women) were recruited from the ongoing community-based Asymptomatic Polyvascular Abnormalities Community Study. ABI was measured and a low ABI was defined as <0.9. Cognition status was evaluated via the Mini-Mental Status Exam. Multivariate logistic regression models and linear regression models were used to assess the association between ABI and cognitive impairment.



A low ABI was associated with cognitive impairment (odds ratio, OR = 1.983; 95% confidence interval, CI: 1.150-3.419), independent of the potential confounders. In addition, a decreasing ABI (per standard deviation) was significantly associated with cognitive impairment in fully adjusted models (OR = 1.156; CI: 1.013-1.319) and with a significant trend of decreasing MMSE scores (β = 0.703, 95% CI 0.189-1.218, p = 0.0074). Furthermore, the odds of a low ABI associated with cognitive impairment in participants without hypertension and participants with diabetes were 4.924 (CI: 1.860-13.035) and 6.393 (CI: 2.431-16.810), respectively.



A low ABI is associated with cognitive impairment, especially in non-hypertensive and diabetic patients.
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100050, China; Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
Anxin
A
Wang
Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
Ruixuan
R
Jiang
Department of Epidemiology and Health Statistics, Academy of Public Health and Management, Weifang Medical University, Weifang, China.
Zhaoping
Z
Su
Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
Jiaokun
J
Jia
Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
Ning
N
Zhang
Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
Jianwei
J
Wu
Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China. Electronic address: csywindy@163.com.
Shengyun
S
Chen
Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China. Electronic address: zxq@vip.163.com.
Xingquan
X
Zhao
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
Atherosclerosis; Cognition; Community-based; Peripheral arterial disease