Muhammad Amin Shaik1, Narayanaswamy Venketasubramanian2, Ching-Yu Cheng3, Tien Yin Wong4, Henri Vrooman5, Mohammad Kamran Ikram6, Saima Hilal7, Christopher Chen1. 1. Memory Aging & Cognition Centre, National University Health System, Singapore; Department of Pharmacology, National University of Singapore, Singapore. 2. Raffles Neuroscience Centre, Raffles Hospital, Singapore. 3. Singapore Eye Research Institute, Singapore National Eye Center, Singapore. 4. Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Academic Medicine Research Institute, Duke-NUS Graduate Medical School, Singapore. 5. Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands. 6. Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands. 7. Memory Aging & Cognition Centre, National University Health System, Singapore; Department of Pharmacology, National University of Singapore, Singapore; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: phchs@nus.edu.sg.
Abstract
BACKGROUND AND AIMS: Previous studies showed an independent association of low ankle-brachial index (ABI) with cognitive impairment. However, the association between low ABI and cognition in the presence of both cerebrovascular disease (CeVD) and neurodegeneration is lacking. We aimed at investigating a) the association of low ABI with markers of CeVD and cortical thickness, and b) whether the association of low ABI with cognition is influenced by these markers. METHODS: Data was drawn from the Epidemiology of Dementia In Singapore (EDIS) study where all participants (n = 832) underwent neuropsychological tests and 3T brain magnetic resonance imaging (MRI) to assess CeVD markers as well as cortical thicknesses. Cognitive function was expressed as a global composite z-score and domain-specific z-scores of a comprehensive neuropsychological battery. RESULTS: Multivariate analyses showed low ABI to be independently associated with intracranial stenosis [odds ratios (OR): 1.51; 95% confidence interval (CI):1.23-1.87] and lacunar infarcts [OR: 1.29; 95% CI: 1.06-1.57]. A low ABI was also independently associated with smaller cortical thickness globally [β: 0.09; 95% CI: 0.27-0.16] as well as with the limbic [β: 0.10; 95% CI: 0.03-0.17], temporal [β: 0.09; 95% CI: 0.02-0.15], parietal [β: 0.08; 95% CI: 0.02-0.15], and occipital [β: 0.09; 95% CI: 0.03-0.16] lobes. Low ABI was associated with worse performance in verbal memory [β: 0.06; 95% CI: 0.01-0.12], which became attenuated in the presence of MRI markers. CONCLUSIONS: A low ABI is associated with MRI markers, and affects cognition in the presence of CeVD and neurodegeneration. Atherosclerosis should be targeted as a potentially modifiable risk factor to prevent cognitive disorders.
BACKGROUND AND AIMS: Previous studies showed an independent association of low ankle-brachial index (ABI) with cognitive impairment. However, the association between low ABI and cognition in the presence of both cerebrovascular disease (CeVD) and neurodegeneration is lacking. We aimed at investigating a) the association of low ABI with markers of CeVD and cortical thickness, and b) whether the association of low ABI with cognition is influenced by these markers. METHODS: Data was drawn from the Epidemiology of Dementia In Singapore (EDIS) study where all participants (n = 832) underwent neuropsychological tests and 3T brain magnetic resonance imaging (MRI) to assess CeVD markers as well as cortical thicknesses. Cognitive function was expressed as a global composite z-score and domain-specific z-scores of a comprehensive neuropsychological battery. RESULTS: Multivariate analyses showed low ABI to be independently associated with intracranial stenosis [odds ratios (OR): 1.51; 95% confidence interval (CI):1.23-1.87] and lacunar infarcts [OR: 1.29; 95% CI: 1.06-1.57]. A low ABI was also independently associated with smaller cortical thickness globally [β: 0.09; 95% CI: 0.27-0.16] as well as with the limbic [β: 0.10; 95% CI: 0.03-0.17], temporal [β: 0.09; 95% CI: 0.02-0.15], parietal [β: 0.08; 95% CI: 0.02-0.15], and occipital [β: 0.09; 95% CI: 0.03-0.16] lobes. Low ABI was associated with worse performance in verbal memory [β: 0.06; 95% CI: 0.01-0.12], which became attenuated in the presence of MRI markers. CONCLUSIONS: A low ABI is associated with MRI markers, and affects cognition in the presence of CeVD and neurodegeneration. Atherosclerosis should be targeted as a potentially modifiable risk factor to prevent cognitive disorders.
Authors: Mahwesh Saleem; Nathan Herrmann; Adam Dinoff; Graham Mazereeuw; Paul I Oh; Benjamin I Goldstein; Alex Kiss; Prathiba Shammi; Krista L Lanctôt Journal: Psychosom Med Date: 2019 Feb/Mar Impact factor: 4.312