Longitudinal Trajectories of Cognitive Decline among Older Adults with Cardiovascular Disease

Okonkwo, Ozioma C.; Cohen, Ronald A.; Gunstad, John; Tremont, Geoffrey; Alosco, Michael L.; Poppas, Athena

doi:10.1159/000319564

Cited by 64 publications

(36 citation statements)

References 101 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Tests included in these domains involved visuospatial and visuoconstructive abilities, attention, visual and working memory, executive functions, verbal fluency and psychomotor speed. Results are in line with previous studies [7,27,28]. Deficits in these cognitive abilities have also been described among the most characteristic of VCI [3,4].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Cognitive Patterns in Relation to Biomarkers of Cerebrovascular Disease and Vascular Risk Factors

Miralbell

López‐Cancio²,

López-Olóriz³

et al. 2013

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: Risk factors for vascular cognitive impairment (VCI) are the same as traditional risk factors for cerebrovascular disease (CVD). Early identification of subjects at higher risk of VCI is important for the development of effective preventive strategies. In addition to traditional vascular risk factors (VRF), circulating biomarkers have emerged as potential tools for early diagnoses, as they could provide in vivo measures of the underlying pathophysiology. While VRF have been consistently linked to a VCI profile (i.e., deficits in executive functions and processing speed), the cognitive correlates of CVD biomarkers remain unclear. In this population-based study, the aim was to study and compare cognitive patterns in relation to VRF and circulating biomarkers of CVD. Methods: TheBarcelona-AsIA Neuropsychology Study included 747 subjects older than 50, without a prior history of stroke or coronary disease and with a moderate to high vascular risk (mean age, 66 years; 34.1% women). Three cognitive domains were derived from factoral analysis: visuospatial skills/speed, verbal memory and verbal fluency. Multiple linear regression was used to assess relationships between cognitive performance (multiple domains) and a panel of circulating biomarkers, including indicators of inflammation, C-reactive protein (CRP) and resistin, endothelial dysfunction, asymmetric dimethylarginine (ADMA), thrombosis, plasminogen activator inhibitor 1 (PAI-1), as well as traditional VRF, metabolic syndrome and insulin resistance (homeostatic model assessment for insulin resistance index). Analyses were adjusted for age, gender, years of education and depressive symptoms. Results: Traditional VRF were related to lower performance in verbal fluency, insulin resistance accounted for lower performance in visuospatial skills/speed and the metabolic syndrome predicted lower performance in both cognitive domains. From the biomarkers of CVD, CRP was negatively related to verbal fluency performance and increasing ADMA levels were associated with lower performance in verbal memory. Resistin and PAI-1 did not relate to cognitive function performance. Conclusion: Vascular risk factors, and markers of inflammation and endothelial dysfunction predicted lower performance in several cognitive domains. Specifically, cognitive functions associated with CRP are typically affected in VCI and overlap those related to VRF. ADMA indicated a dissociation in the cognitive profile involving verbal memory. These findings suggest that inflammation and endothelial dysfunction might play a role in the predementia cognitive impairment stages.

show abstract

Section: Discussionsupporting

confidence: 92%

“…Early identification of subjects who are at high risk of VCI is extremely important since preventive and treatment measures would be more effective if started during preclinical stages [6,7]. Risk factors for VCI are the same as traditional risk factors for CVD [8].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Patterns in Relation to Biomarkers of Cerebrovascular Disease and Vascular Risk Factors

Miralbell

López‐Cancio²,

López-Olóriz³

et al. 2013

Cerebrovasc Dis

View full text Add to dashboard Cite

show abstract

“…Vascular risk factors (VRF) have been consistently related to cognitive impairment and dementia [1,2,3]. Vascular Cognitive Impairment (VCI) is associated with stroke and with subclinical ischemic brain lesions [4], and there is increasing interest in its relevance and contribution to cognitive dysfunction [5].…”

Section: Introductionmentioning

confidence: 99%

Diffusion Tensor Imaging, Intracranial Vascular Resistance and Cognition in Middle-Aged Asymptomatic Subjects

López-Olóriz

López‐Cancio²,

Arenillas³

et al. 2014

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: The contribution of traditional vascular risk factors to cognitive impairment and dementia is well known. However, in order to obtain possible targets for prevention of vascular cognitive impairment (VCI), it may be important to identify other early and noninvasive markers in asymptomatic middle-aged adults. The calculation of middle cerebral artery-pulsatility index (MCA-PI) is an ultrasonologic, noninvasive, validated and easily reproducible technique to assess increased distal resistance to blood flow. This study aims to assess the relationship between MCA-PI, microstructural white matter (WM) integrity and cognition in a middle-aged asymptomatic population. Methods: Ninety-five participants from the Barcelona-Asymptomatic Intracranial Atherosclerosis (AsIA) neuropsychology study were included. Subjects were 50-65 years old, free from dementia and without history of vascular disease. Transcranial color-coded duplex ultrasound examination was performed to assess MCA-PI as a measure of vascular resistance. WM integrity was evaluated by fractional anisotropy (FA) measurements of diffusion tensor images (DTI) acquired on a 3T-MRI. The neuropsychological battery was specifically selected to be sensitive to VCI, and included tests that were grouped into six cognitive domains: executive functioning, attention, verbal fluency, memory, visuospatial skills and psychomotor speed. A multivariate linear regression model adjusted for age, gender, years of education, diabetes and hypertension was performed. Results: MCA-PI was significantly associated with WM disintegration in different tracts (fornix, corticospinal and anterior thalamic), all p < 0.05 uncorrected. Both mean MCA-PI and mean FA of those significant tracts were independently associated with poor performance in attention, psychomotor speed, and visuospatial skills after adjustment for age, gender, years of education, and vascular risk factors (all p < 0.05). MCA-PI was independently associated with lower scores in all cognitive domains, except for visuospatial skills. Conclusions: Our data suggest that MCA-PI may be related to WM disintegration and early vascular cognitive impairment in middle-aged subjects. Although further prospective studies are needed to provide evidence for its validity in longitudinal studies, our results support the proposal of including MCA-PI as part of clinical assessment in order to identify targets for VCI prevention.

show abstract

“…Individuals with CVD have also been shown to exhibit decrements in cognitive functions such as attention, executive function, memory and verbal learning (Moser et al, 1999;Okonkwo et al, 2010;Silbert et al, 2007;Singh-Manoux et al, 2003;Vogels et al, 2007). Although the cognitive decrements observed among cardiac patients would not typically be sufficient to lead to a diagnosis of dementia or mild cognitive impairment, even subtle decreases in cognitive function may negatively impact complex cognitive tasks (Wadley et al, 2008), such as automobile driving.…”

Section: Introductionmentioning

confidence: 99%

Investigating the autonomic nervous system and cognitive functions as potential mediators of an association between cardiovascular disease and driving performance

Gaudet

Bélanger²,

Corriveau

et al. 2013

Can. J. Physiol. Pharmacol.

View full text Add to dashboard Cite

Cardiovascular disease (CVD) impacts the autonomic nervous system and cognitive functions related to activities of daily living, including driving an automobile. Although CVD has been linked to unsafe driving, mechanisms underlying this relationship remain elusive. The aim of this study was to examine the role of cognitive functions and the autonomic nervous system as potential mediators of driving performance. Nineteen individuals having recently suffered a cardiac event and sixteen individuals with no history of CVD completed a simulated drive using a STISIM simulator to assess driving performance. Heart rate was recorded throughout testing using a Polar RS800CX heart rate monitor and measures of executive, orienting and alerting functions were obtained through the Attention Network Test. We used the Baron and Kenny analysis method to assess potential mediating effects of the relationship between CVD and driving performance. Executive function was the only potential mediator investigated to be associated with driving (p < 0.01) and CVD (p < 0.05), however, it did not appear to play a mediating role (p = 0.28). These results suggest that individuals with CVD exhibit decrements in complex cognitive tasks such as driving and that further research is needed to better understand the mechanisms underlying this relationship.

show abstract

Longitudinal Trajectories of Cognitive Decline among Older Adults with Cardiovascular Disease

Cited by 64 publications

References 101 publications

Cognitive Patterns in Relation to Biomarkers of Cerebrovascular Disease and Vascular Risk Factors

Cognitive Patterns in Relation to Biomarkers of Cerebrovascular Disease and Vascular Risk Factors

Diffusion Tensor Imaging, Intracranial Vascular Resistance and Cognition in Middle-Aged Asymptomatic Subjects

Investigating the autonomic nervous system and cognitive functions as potential mediators of an association between cardiovascular disease and driving performance

Contact Info

Product

Resources

About