Vascular Function in Alzheimer’s Disease and Vascular Dementia

Abstract

We investigated vascular functioning in patients with a clinical and radiological diagnosis of either Alzheimer's disease (AD) or vascular dementia (VaD) and examined a possible relationship between vascular function and cognitive status. Twenty-seven patients with AD, 23 patients with VaD, and 26 healthy control patients underwent measurements of flow-mediated dilation (FMD), ankle-brachial index (ABI), cardioankle vascular index (CAVI), and intima-media thickness (IMT). The FMD was significantly lower in patients with AD or VaD compared to controls. There were no significant differences in ABI, CAVI, or IMT among the 3 groups. A significant correlation was found between Mini-Mental State Examination (MMSE) scores and FMD. Furthermore, a multiple regression analysis revealed that FMD was significantly predicted by MMSE scores. These results suggest that endothelial involvement plays a role in AD pathogenesis, and FMD may be more sensitive than other surrogate methods (ABI, CAVI, and IMT) for detecting early-stage atherosclerosis and/or cognitive decline.

Biomarkers Related to Endothelial Dysfunction and Vascular Cognitive Impairment: A Systematic Review

“…In patients with severe sporadic SVD or VaD, there is a lower FMD when compared with control subjects, in agreement with concomitant findings of reduced CVR [45, 51]. These findings suggest that in the setting of CSVD, the vasoreactivity impairment may also be found in systemic vessels and could be more easily accessible through peripheral vessels than through cerebral vessels [45].…”

“…A positive, though weak, correlation between CVR and FMD was found in CSVD patients, suggesting an association between peripheral and cerebral vasoreactivity dysfunction in this population [45]. Moreover, the significant correlation between FMD and Mini-Mental State Examination (MMSE) implies that ED relates to cognitive impairment [51]. Reduced FMD has also been reported among AD subjects, suggesting that ED may also play a role in neurodegenerative pathologies [51].…”

Microvascular Endothelial Function and Neurocognition Among Adults With Major Depressive Disorder

“…(12) These findings have subsequently been replicated, with systematic literature reviews demonstrating that flow-mediated dilation (FMD), a marker of endothelial function,(13, 38) demonstrates consistent inverse associations with frontal-lobe dependent test performance. (39) Consistent with the present findings, prior studies have reported that flow-mediated dilation is not related to memory performance,(39) despite numerous recent studies demonstrating that endothelial dysfunction is commonly observed among individuals with Alzheimer’s disease (8, 9, 40-42) and may play an important role in the pathogenesis of neurodegeneration. (8, 43, 44)…”

Impact of Nitric Oxide Bioavailability on the Progressive Cerebral and Peripheral Circulatory Impairments During Aging and Alzheimer's Disease

“…Along with cortical alteration of blood flow, few studies reported evidence that peripheral vascular dysfunction determined by ankle-to-brachial index, flow-mediated dilation, intima-media thickness, and endothelial microvascular response to acetylcholine are associated with AD (Dede et al, 2007 ; Khalil et al, 2007 ; Laurin et al, 2007 ; Tachibana et al, 2016 ). This literature suggests that systemic vascular impairments are determined by AD, or from a different point of view, that systemic vascular dysfunctions may trigger AD (De La Torre, 2004 ).…”