4.5 Article

Associations Between Cerebral Vasoreactivity and Cognitive Function in the Middle-Aged Non-Demented Population

Journal

JOURNAL OF ALZHEIMERS DISEASE
Volume 86, Issue 2, Pages 679-690

Publisher

IOS PRESS
DOI: 10.3233/JAD-215317

Keywords

Alzheimer's disease; cerebrovascular reactivity; cognitive impairment; vasomotor system; vasoreactivity

Categories

Funding

  1. Ministry of Science and Technology, Taiwan [MOST 1092314-B-075-048-MY2, MOST 109-2314-B-075084, MOST109-2321-B-009-007, MOST 106-2314-B-010-044, MOST 110-2321-B-010-007]
  2. Taipei Veterans General Hospital [V110C-044]

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The study aimed to evaluate the relationship between brain vascular hemodynamic parameters and cognitive functions in middle-aged adults without dementia. The results showed that neurovascular abnormalities play a role in the early pathophysiology of cognitive impairment, and cerebral vasoreactivity is the earliest detectable cognition-associated hemodynamic parameter.
Background: Increasing evidence shows early vascular dysregulation in the pathophysiology of Alzheimer's disease (AD) in elderly population. Objective: We wondered about the relationship between vascular health and cognitive performance in middle-aged adults. The present study aims to evaluate whether and which brain vascular hemodynamic parameters are associated with cognitive functions in a middle-aged, non-demented population. Methods: We recruited 490 middle-aged community-based participants (30-60 years). Transcranial color-coded sonography was used to measure cerebral vascular hemodynamics, including mean flow velocity, pulsatility index, and breath-holding index (BHI) in the middle cerebral arteries (MCAs). Cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA). A multivariate linear regression model was used to determine the association between the MoCA scores and each intracranial hemodynamic parameter. Results: In 369 participants (median age 52 years [IQR 47-56], 48.8% men) with robust acoustic windows, the factors related to poorer MoCA scores were older age, less education extent, and the habitats of cigarette smoking or alcohol consumption. Multivariate analyses did not show a significant association between any intracranial hemodynamic parameters in both MCAs and MoCA scores in the total study population. Left MCA BHI was found to be significantly and independently correlated with the MoCA scores only in people aged 55-60 years (n = 111, B = 0.70, 95% confidence interval, 0.13-1.26, p = 0.017), however, not in people younger than 55 years. Conclusion: Our results emphasize the role of neurovascular abnormalities in the early pathophysiology of cognitive impairment and suggest cerebral vasoreactivity as the earliest detectable cognition-associated hemodynamic parameter.

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