Serum alkaline phosphatase is related to cognitive impairment in patients with subcortical ischemic vascular disease

Abstract

Background: The aim of the present study was to assess the relationship between serum levels of Alkaline Phosphatase (ALP) and cognitive impairments in patients with Subcortical Ischemic Vascular Disease (SIVD). Methods: This study included 235 patients who were assigned to a mild-cognitive-impairment group or a vascular-dementia group according to the severity of their cognitive impairments. The incidences of multiple lacunar infarctions and leukoaraiosis were confirmed using Magnetic Resonance Imaging (MRI) scans. Serum ALP was measured with an enzymatic method; the Mini-mental State Examination (MMSE) and the Cambridge Cognitive Examination-Chinese version (CAMCOG-C) were used to assess neuropsychological status; and a logistic regression was performed to explore the associations between ALP levels and cognitive impairments. Results: ALP levels were higher in the vascular-dementia group than in the control group (82.7 ± 15.06 vs. 68.4 ± 14.8, respectively), and scores on the MMSE and CAMCOG-C were significantly lower in the vascular-dementia than in the mild-cognitive-impairment group. Additionally, ALP levels were negatively correlated with MMSE and CAMCOG-C scores (r=-0.364 and r=-0.297, respectively). The incidences of lacunar infarction and leukoaraiosis were higher in the vascular-dementia group than in the mild-cognitive-impairment group (73.9% vs. 60.0% and 80.0% vs. 64.2%, respectively), and the logistic regression revealed that ALP levels were positively associated with cognitive impairments after adjusting for potential confounding factors (Odds Ratio (OR): 1.57, 95% Confidence Interval (CI): 1.14-2.17). Furthermore, the risk of cognitive impairments increased by 57% per unit of ALP change.