Ankle-brachial index as a marker of cognitive impairment and dementia in general population. A systematic review

Objective: To investigate the association between a low ankle-brachial index (ABI) and several grades of cognitive disorders: cognitive impairment, dementia and Alzheimer's disease (AD), in the general population. Methods: We performed a systematic review of the literature, including all prospective, longitudinal or cross-sectional studies assessing both peripheral artery disease (PAD), defined by a low ABI, and cognitive function. Results: 12 publications were included in this review, of whom 6 reported cross-sectional analysis and 6 reported longitudinal analysis. All except one reported a significant association between a low ankle-brachial index and cognitive impairment, dementia or AD. Beyond cognitive impairment, patients with PAD are at an increased risk to develop dementia or Alzheimer's disease. Conclusion: In this review, we confirm that a low (<0.90) ABI can be considered as a marker of cognitive impairment and dementia. ABI provides independent and supplemental information on subject's susceptibility to develop cognitive disorders, along its usefulness to predict cardiovascular diseases (CVD). Given its availability, easiness, safety to patients and low cost, the ABI could be useful in clinical practice and research in the field of cognitive diseases. (C) 2011 Elsevier Ireland Ltd. All rights reserved.