Vascular Health Indices and Cognitive Domain Function: Singapore Longitudinal Ageing Studies
Vascular Health Indices and Cognitive Domain Function: Singapore Longitudinal Ageing Studies
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DOI：
10.3233/jad-150516
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发表时间：
2016-01-01
影响因子：
4
通讯作者：
Ng, Tze Pin
中科院分区：
文献类型：
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作者：
Lim, Shir Lynn;Gao, Qi;Ng, Tze Pin
背景资料：很少有研究全面评估血管疾病与无心脏病老年人认知之间的关系。目的：我们探讨了结构性动脉粥样硬化、血管僵硬度和反应性与社区居住的无心脏病非痴呆老年亚洲人的全局、记忆、注意力、语言、视觉空间能力和执行功能之间的关系。方法：认知能力通过简易精神状态检查（MMSE）（n = 308）和详细的神经心理学测试（n = 155）进行评估。血管测量包括颈动脉内膜中层厚度;主动脉僵硬度[颈动脉-股动脉脉搏波速度（CFPWV）、主动脉增强指数（AI）和主动脉脉压（PP）];颈动脉僵硬度[弹性模量（Ep）、β指数（β）、动脉顺应性（AC）、颈动脉AI];和内皮功能[反应性充血指数（RHI）]。多变量分析控制了人口统计学、载脂蛋白E基因型和心血管危险因素的潜在混杂因素。结果：参与者的平均年龄为63.0 ± 6.1岁。AC与MMSE呈负相关（β = 0.128，p = 0.019），Ep（β =-0.151，p = 0.008），β指数（β =-0.122，p = 0.029），颈动脉僵硬度z评分（β =-0.154，p = 0.007）;具有CFPWV执行功能（β =-0.209，p = 0.026），AC（β = 0.214，p = 0.005），Ep（β =-0.160，p = 0.050），β指数（β =-0.165，p = 0.041），两个主动脉（β =-0.229，p = 0.010）和颈动脉（β =-0.208，p = 0.010）僵硬度z评分; AI的言语记忆（β =-0.229，p = 0.004）和主动脉（β =-0.263，p = 0.004）僵硬度z评分; AI语言（β =-0.155，p = 0.025），主动脉僵硬度z评分（β =-0.196，p = 0.011）。RHI与视觉空间能力（beta = 0.195，p = 0.013）和执行功能（beta = 0.151，p = 0.045.Conclusion）呈正相关。动脉僵硬度和反应性的亚临床非侵入性测量可以识别易受认知障碍影响的个体。
Background: Few studies have comprehensively evaluated the relationship between vascular disease and cognition of older adults without cardiac disease.Objective: We explored the associations of structural atherosclerosis, vascular stiffness, and reactivity with global, memory, attention, language, visuospatial ability, and executive function in community-dwelling, non-demented older Asians without cardiac diseases.Methods: Cognition was assessed by Mini-Mental State Examination (MMSE) (n = 308) and detailed neuropsychological tests (n = 155). Vascular measures included carotid intima-media thickness; aortic stiffness [carotid-femoral pulse wave velocity (CFPWV), aortic augmentation index (AI), and aortic pulse pressure (PP)]; carotid stiffness [elasticity modulus (Ep), beta index (beta), arterial compliance (AC), carotid AI]; and endothelial function [reactive hyperemia index (RHI)]. Multivariable analyses controlled for potential confounding by demographics, apolipoprotein E genotype and cardiovascular risk factors.Results: The participants' mean age was 63.0 +/- 6.1 years. Inverse associations with MMSE were found for AC (beta = 0.128, p = 0.019), Ep (beta = -0.151, p = 0.008), beta index (beta = -0.122, p = 0.029), carotid stiffness z-score (beta = -0.154, p = 0.007); with executive function for CFPWV(beta = -0.209, p = 0.026), AC(beta = 0.214, p = 0.005), Ep (beta = -0.160, p = 0.050), beta index (beta = -0.165, p = 0.041), and both aortic (beta = -0.229, p = 0.010) and carotid (beta = -0.208, p = 0.010) stiffness z-scores; with verbal memory for AI (beta = -0.229, p = 0.004) and aortic (beta = -0.263, p = 0.004) stiffness z-score; with language for AI (beta = -0.155, p = 0.025), aortic stiffness z-score (beta = -0.196, p = 0.011). RHI positively correlated with visuospatial ability (beta = 0.195, p = 0.013) and executive function (beta = 0.151, p = 0.045).Conclusion: The results support a link between systemic vascular health and neurocognitive function in older Asian adults. Subclinical noninvasive measures of arterial stiffness and reactivity may identify individuals vulnerable to cognitive impairment.