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Microvascular and Macrovascular Abnormalities and Cognitive and Physical Function in Older Adults: Cardiovascular Health Study.
Tuesday,2015-10-06 13:49 America/Los_Angeles — zdrager
| Title | Microvascular and Macrovascular Abnormalities and Cognitive and Physical Function in Older Adults: Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Kim, DHyun, Grodstein, F, Newman, AB, Chaves, PHM, Odden, MC, Klein, R, Sarnak, MJ, Lipsitz, LA |
| Journal | J Am Geriatr Soc |
| Volume | 63 |
| Issue | 9 |
| Pagination | 1886-93 |
| Date Published | 2015 Sep |
| ISSN | 1532-5415 |
| Keywords | Aged, Aged, 80 and over, Cognition, Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Vascular Malformations |
| Abstract | <p><b>OBJECTIVES: </b>To evaluate and compare the associations between microvascular and macrovascular abnormalities and cognitive and physical function</p><p><b>DESIGN: </b>Cross-sectional analysis of the Cardiovascular Health Study (1998-1999).</p><p><b>SETTING: </b>Community.</p><p><b>PARTICIPANTS: </b>Individuals with available data on three or more of five microvascular abnormalities (brain, retina, kidney) and three or more of six macrovascular abnormalities (brain, carotid artery, heart, peripheral artery) (N = 2,452; mean age 79.5).</p><p><b>MEASUREMENTS: </b>Standardized composite scores derived from three cognitive tests (Modified Mini-Mental State Examination, Digit-Symbol Substitution Test, Trail-Making Test (TMT)) and three physical tests (gait speed, grip strength, 5-time sit to stand)</p><p><b>RESULTS: </b>Participants with high microvascular and macrovascular burden had worse cognitive (mean score difference = -0.30, 95% confidence interval (CI) = -0.37 to -0.24) and physical (mean score difference = -0.32, 95% CI = -0.38 to -0.26) function than those with low microvascular and macrovascular burden. Individuals with high microvascular burden alone had similarly lower scores than those with high macrovascular burden alone (cognitive function: -0.16, 95% CI = -0.24 to -0.08 vs -0.13, 95% CI = -0.20 to -0.06; physical function: -0.15, 95% CI = -0.22 to -0.08 vs -0.12, 95% CI = -0.18 to -0.06). Psychomotor speed and working memory, assessed using the TMT, were only impaired in the presence of high microvascular burden. Of the 11 vascular abnormalities considered, white matter hyperintensity, cystatin C-based glomerular filtration rate, large brain infarct, and ankle-arm index were independently associated with cognitive and physical function.</p><p><b>CONCLUSION: </b>Microvascular and macrovascular abnormalities assessed using noninvasive tests of the brain, kidney, and peripheral artery were independently associated with poor cognitive and physical function in older adults. Future research should evaluate the usefulness of these tests in prognostication.</p> |
| DOI | 10.1111/jgs.13594 |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 26338279 |
| PubMed Central ID | PMC4578971 |
| Grant List | 1KL2 TR001100-01 / TR / NCATS NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States K01 AG039387 / AG / NIA NIH HHS / United States KL2 TR001100 / TR / NCATS NIH HHS / United States N01HC-85083 / HC / NHLBI NIH HHS / United States N01HC55222 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States NHLBI-HC-97-06 / HC / NHLBI NIH HHS / United States P01 AG004390 / AG / NIA NIH HHS / United States P01-AG-004390 / AG / NIA NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States R01 AG041785 / AG / NIA NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01-AG-023629 / AG / NIA NIH HHS / United States R01-AG-027002 / AG / NIA NIH HHS / United States R01-AG-041785 / AG / NIA NIH HHS / United States R21 HL077166 / HL / NHLBI NIH HHS / United States R21-HL-077166 / HL / NHLBI NIH HHS / United States R37 AG025037 / AG / NIA NIH HHS / United States R37-AG-25037 / AG / NIA NIH HHS / United States |