Arterial Stiffness Predicts Cognitive Decline in Japanese Community-dwelling Elderly Subjects: A One-year Follow-up Study

Yukutake, Taiki; Yamada, Minoru; Fukutani, Naoto; Nishiguchi, Shu; Kayama, Hiroki; Tanigawa, Tetsuya; Adachi, Daiki; Hotta, T; Morino, Saori; Tashiro, Yuto; Aoyama, Tomoki; Arai, Hidenori

doi:10.5551/jat.27391

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…Microvascular brain damage, such as microinfarction, microhemorrhage, and macrohemorrhage 3, 4) , as well as peripheral arterial stiffness 5, 6) , heighten the risk of cognitive impairment. Previous studies have suggested that such brain abnormalities may be associated with retinal vascular changes due to shared embryological, anatomical, and physiological features 7–9) .…”

Section: Introductionmentioning

confidence: 99%

Retinal Vascular Changes and Prospective Risk of Disabling Dementia: the Circulatory Risk in Communities Study (CIRCS)

Jinnouchi

Kitamura

Yamagishi

et al. 2017

J Atheroscler Thromb

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Aim: To investigate the association of retinal vascular changes with a risk of dementia in longitudinal population-based study.Methods: We performed a nested case-control study of 3,718 persons, aged 40–89 years, enrolled between 1983 and 2004. Retinal vascular changes were observed in 351 cases with disabling dementia (average period before the onset, 11.2 years) and in 702 controls matched for sex, age, and baseline year. Incidence of disabling dementia was defined as individuals who received cares for disabilities including dementia-related symptoms and/or behavioral disturbance. Conditional logistic regression analysis was used to calculate odds ratio (OR) and multivariable adjusted OR (Models 1 and 2) for incidence of disabling dementia according to each retinal vascular change. Regarding confounding variables, Model 1 included overweight status, hypertension, hyperglycemia, dyslipidemia, and smoking status, whereas Model 2 also included incidence of stroke prior to disabling dementia for further analysis.Results: The proportion of cases (controls) with retinal vascular changes was 23.1 (15.7)% for generalized arteriolar narrowing, 7.7 (7.5)% for focal arteriolar narrowing, 15.7 (11.8)% for arteriovenous nicking, 10.5 (9.3)% for increased arteriolar wall reflex, and 11.4 (9.8)% for any other retinopathy. Generalized arteriolar narrowing was associated with an increased risk of disabling dementia: crude OR, 1.66 (95% confidence interval, 1.19–2.31); Model 1: OR, 1.58 (1.12–2.23); Model 2: OR, 1.48 (1.04–2.10). The number of retinal abnormalities was associated in a dose–response manner with the risk.Conclusion: Generalized arteriolar narrowing and total number of retinal abnormalities may be useful markers for identifying persons at higher risks of disabling dementia.

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Section: Introductionmentioning

confidence: 99%

Retinal Vascular Changes and Prospective Risk of Disabling Dementia: the Circulatory Risk in Communities Study (CIRCS)

Jinnouchi

Kitamura

Yamagishi

et al. 2017

J Atheroscler Thromb

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“…Recently, numerous studies have also shown novel associations between cognitive impairment and arterial stiffness [10][11][12][13][14][15] . Methods for assessing arterial stiffness are noninvasive and allow simple assessment and data evaluation.…”

Section: Outlinementioning

confidence: 99%

“…Thus, an increased ABI indicates arterial calcification that leads to vessel sclerosis (advanced vessel stiffness). Increased PWV is also associated with cognitive impairment [12,14] , an independent predictor of cognitive decline [10,11] , and β-amyloid (Aβ) deposition in the brains of older patients [15] . More specifically, Hughes et al [15] showed the associations between arterial stiffness and Aβ deposition in the brain independent of blood pressure.…”

Section: Cognitive Impairmentmentioning

confidence: 99%

Cerebral Small Vessel Disease and Arterial Stiffness: Tsunami Effect in the Brain

Saji

Toba

Sakurai³

2015

Pulse

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Background: Cerebral small vessel diseases, including silent lacunar infarcts, white matter hyperintensities, and microbleeds, pose a risk for cerebrovascular disease, cognitive impairment, and the geriatric syndrome via effects on arterial stiffness. However, the vascular, physiological, and metabolic roles of arterial stiffness in cerebral small vessel diseases remain unclear. Summary: Arterial stiffness can be assessed using various indicators such as the ankle-brachial index, pulse wave velocity, cardio-ankle vascular index, and augmentation index. Arterial stiffness is independently associated with all components of cerebral small vessel disease including silent lacunar infarcts, white matter hyperintensities, and microbleeds, although there are some methodological differences between the various surrogate markers. Evidence of arterial stiffness indicates microvessel arteriosclerosis presenting with vascular endothelial dysfunction. Further, vascular narrowing due to atherosclerosis and vascular stiffness due to lipohyalinosis can accelerate the pulse waves. This hemodynamic stress, pulsatile pressure, or blood pressure variability can cause a 'tsunami effect' towards the cerebral parenchyma and lead to cerebral small vessel disease. Previous studies have shown that silent lacunar infarcts and white matter hyperintensities are strongly associated with arterial stiffness. However, the association between microbleeds and arterial stiffness remains controversial, as there are two vessel mechanisms related to microbleeds: cerebral amyloid angiopathy and hypertensive small vessel disease. Key Messages: Cerebral small vessel disease with as- www.karger.com/pls © 2016 S. Karger AG, Basel sociated arterial stiffness is a risk factor for silent cerebral lesions, stroke, and cognitive impairment. Improvement of the living environment, management of risk factors, and innovation and development of novel drugs that improve arterial stiffness may suppress the progression of cerebral small vessel disease, and may reduce the risk for stroke and dementia.

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“…WMH are a well‐known risk factor for cognitive impairment . Cognitive impairment including dementia is also independently associated with arterial stiffness . An ABI greater than 1.30 and increased blood pressure variability are important predictors of cognitive impairment among patients without vascular diseases .…”

Section: Wmh and Arterial Stiffnessmentioning

confidence: 99%

“…20 Cognitive impairment including dementia is also independently associated with arterial stiffness. [21][22][23][24] An ABI greater than 1.30 and increased blood pressure variability are important predictors of cognitive impairment among patients without vascular diseases. 21 Furthermore, increased PWV is associated with cognitive impairment, 25 an independent predictor of cognitive decline, 23 and β-amyloid deposition in the brains of older adults.…”

Section: Cognitive Impairmentmentioning

confidence: 99%

White matter hyperintensities and geriatric syndrome: An important role of arterial stiffness

Saji

Ogama

Toba

et al. 2015

Geriatrics Gerontology Int

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White matter hyperintensities (WMH) are defined as cerebral white matter changes presumed to be of vascular origin, bilateral and mostly symmetrical. They can appear as hyperintense on T2-weighted and fluid-attenuated inversion recovery sequences, and as isointense or hypointense on T1-weighted magnetic resonance imaging of the brain. WMH have been focused on because of their clinical importance as a risk factor for cerebrovascular diseases and cognitive impairment. WMH are associated with geriatric syndrome, which is defined by clinical symptoms characteristic of older adults, including cognitive and functional impairment and falls. Cerebral small vessel diseases, such as WMH, might play an important role as risk factors for cerebrovascular diseases, cognitive impairment and geriatric syndrome through the mechanism of arterial stiffness. However, the vascular, physiological and metabolic roles of arterial stiffness remain unclear. Basically, arterial stiffness indicates microvessel arteriosclerosis presenting with vascular endothelial dysfunction. These changes might arise from hemodynamic stress as a result of a "tsunami effect" on cerebral parenchyma. In the present article, we review the clinical characteristics of WMH, focusing particularly on two associations: (i) those between cerebral small vessel diseases including WMH and arterial stiffness; and (ii) those between WMH and geriatric syndrome. Geriatr Gerontol Int 2015; 15 (Suppl. 1): 17-25.

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Arterial Stiffness Predicts Cognitive Decline in Japanese Community-dwelling Elderly Subjects: A One-year Follow-up Study

Cited by 14 publications

References 27 publications

Retinal Vascular Changes and Prospective Risk of Disabling Dementia: the Circulatory Risk in Communities Study (CIRCS)

Retinal Vascular Changes and Prospective Risk of Disabling Dementia: the Circulatory Risk in Communities Study (CIRCS)

Cerebral Small Vessel Disease and Arterial Stiffness: Tsunami Effect in the Brain

White matter hyperintensities and geriatric syndrome: An important role of arterial stiffness

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