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; Makoto Ono; Nicole Wake; Marie Gerhard-Herman

doi:10.1016/j.artres.2008.01.001

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Volume 2, Issue 1, February 2008, Pages 35 - 43

Vascular health and cognitive function in older adults with cardiovascular disease

Authors

Daniel E. Forman^a^{, b}^{, *}, Ronald A. Cohen^c, Karin F. Hoth^d^{, l}, Andreana P. Haley^e, Athena Poppas^f, David J. Moser^g, John Gunstad^h, Robert H. Paulⁱ, Angela L. Jefferson^j, David F. Tate^k, Makoto Ono^c, Nicole Wake^a, Marie Gerhard-Herman^a

^aDivision of Cardiology, Brigham and Women’s Hospital, Boston, MA, USA

^bGeriatric Research, Education, and Clinical Care, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA

^cDepartment of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA

^dDepartment of Medicine, National Jewish and Medical Research Centre, Denver, CO, USA

^eDepartment of Psychology, University of Texas at Austin, Austin, TX, USA

^fDepartment of Cardiology, Rhode Island Hospital, Brown Medical School, Providence, RI, USA

^gDepartment of Psychiatry, University of Iowa, IA, USA

^hDepartment of Psychology, Kent State University, Kent, OH, USA

ⁱDepartment of Psychology, University of Missouri, St Louis, MO, USA

^jDepartment of Neurology, Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA, USA

^kDepartment of Radiology, Brigham and Women’s Hospital, Boston, MA, USA

^lDepartment of Psychiatry, University of Colorado at Denver and Health Sciences Centre, Denver, CO, USA

^*Corresponding author at: Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA. Tel.: +1 617 732 5672; fax: +1 617 732 7134. E-mail address: deforman@partners.org (D.E. Forman).

Corresponding Author

Daniel E. Forman

Received 10 August 2007, Revised 15 December 2007, Accepted 10 January 2008, Available Online 29 February 2008.

DOI: 10.1016/j.artres.2008.01.001 How to use a DOI?
Keywords: Cardiovascular disease; Vascular function; Age; Endothelium; Neurocognitive performance
Abstract: Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 2 - 1
Pages: 35 - 43
Publication Date: 2008/02/29
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2008.01.001 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - Daniel E. Forman
AU  - Ronald A. Cohen
AU  - Karin F. Hoth
AU  - Andreana P. Haley
AU  - Athena Poppas
AU  - David J. Moser
AU  - John Gunstad
AU  - Robert H. Paul
AU  - Angela L. Jefferson
AU  - David F. Tate
AU  - Makoto Ono
AU  - Nicole Wake
AU  - Marie Gerhard-Herman
PY  - 2008
DA  - 2008/02/29
TI  - Vascular health and cognitive function in older adults with cardiovascular disease
JO  - Artery Research
SP  - 35
EP  - 43
VL  - 2
IS  - 1
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2008.01.001
DO  - 10.1016/j.artres.2008.01.001
ID  - Forman2008
ER  -

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