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Vascular health and cognitive function in older adults with cardiovascular disease
Journal article   Open access   Peer reviewed

Vascular health and cognitive function in older adults with cardiovascular disease

Daniel E Forman, Ronald A Cohen, Karin F Hoth, Andreana P Haley, Athena Poppas, David J Moser, John Gunstad, Robert H Paul, Angela L Jefferson, David F Tate, …
Artery research, Vol.2(1), pp.35-43
2008
DOI: 10.1016/j.artres.2008.01.001
PMCID: PMC3004172
PMID: 21179381
url
https://doi.org/10.1016/j.artres.2008.01.001View
Published (Version of record) Open Access

Abstract

We hypothesized that changes in vascular flow dynamics resulting from age and cardiovascular disease (CVD) would correlate to neurocognitive capacities, even in adults screened to exclude dementia and neurological disease. We studied endothelial-dependent as well as endothelial-independent brachial responses in older adults with CVD to study the associations of vascular responses with cognition. Comprehensive neurocognitive testing was used to discern which specific cognitive domain(s) correlated with the vascular responses. Eighty-eight independent, community-dwelling older adults (70.02 ± 7.67 years) with mild to severe CVD were recruited. Enrollees were thoroughly screened to exclude neurological disease and dementia. Flow-mediated (endothelial-dependent) and nitroglycerin-mediated (endothelial-independent) brachial artery responses were assessed using 2-D ultrasound. Cognitive functioning was assessed using comprehensive neuropsychological testing. Linear regression analyses were used to evaluate the relationships between the endothelial-dependent and endothelial-independent vascular flow dynamics and specific domains of neurocognitive function. Endothelial-dependent and endothelial-independent brachial artery responses both correlated with neurocognitive testing indices. The strongest independent relationship was between endothelial function and measures of attention-executive functioning. Endothelial-dependent and endothelial-independent vascular responsiveness correlate with neurocognitive performance among older CVD patients, particularly in the attention-executive domain. While further study is needed to substantiate causal relationships, our data demonstrate that brachial responses serve as important markers of risk for common neurocognitive changes. Learning and behavior-modifying therapeutic strategies that compensate for such common, insidious neurocognitive limitations will likely improve caregiving efficacy.
Cardiovascular disease Neurocognitive performance Vascular function Age Endothelium

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