TY - JOUR
T1 - Frequent Cognitive Impairment in Patients With Disorders Along the Heart-Brain Axis
AU - Hooghiemstra, Astrid M.
AU - Leeuwis, Anna E.
AU - Bertens, Anne Suzannne
AU - Biessels, Geert Jan
AU - Bots, Michiel L.
AU - Brunner-La Rocca, Hans-Peter
AU - Greving, Jacoba P.
AU - Kappelle, L. Jaap
AU - van Oostenbrugge, Robert J.
AU - van Rossum, Albert C.
AU - van der Flier, Wiesje M.
AU - Heart-Brain Connection Consortium
N1 - Funding Information:
We acknowledge the support of the Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation (CVON 2018-28 & 2012-06 Heart Brain Connection), Dutch Federation of University Medical Centers, the Netherlands Organization for Health Research and Development, and the Royal Netherlands Academy of Sciences. The Alzheimer Center Amsterdam is supported by Alzheimer Nederland and Stichting VUmc fonds. Research of the Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience.
Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/12
Y1 - 2019/12
N2 - Background and Purpose-Patients with cardiovascular disease are at increased risk for cognitive decline. We studied the occurrence and profile of cognitive impairment in 3 patient groups as exemplar conditions of hemodynamic disturbances at different levels of the heart-brain axis, including patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (possible vascular cognitive impairment [VCI]).Methods-In 555 participants (160 HF, 107 COD, 160 possible VCI, 128 reference participants; 689 years; 36% F; Mini-Mental State Examination 282), we assessed cognitive functioning with a comprehensive test battery. Test scores were transformed into z-scores. Compound z-scores were constructed for: memory, language, attention/psychomotor speed, executive functioning, and global cognitive functioning. We rated cognitive domains as impaired when z-scoreResults-Age, sex, and education adjusted global cognitive functioning z-score was lower in patients with COD (beta [SE]=-0.46 [0.10], PConclusions-A substantial part of patients with HF and COD had cognitive impairment, which warrants vigilance for the occurrence of cognitive impairment. These results underline the importance of an integrative approach in medicine in patients presenting with disorders in the heart-brain axis.
AB - Background and Purpose-Patients with cardiovascular disease are at increased risk for cognitive decline. We studied the occurrence and profile of cognitive impairment in 3 patient groups as exemplar conditions of hemodynamic disturbances at different levels of the heart-brain axis, including patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (possible vascular cognitive impairment [VCI]).Methods-In 555 participants (160 HF, 107 COD, 160 possible VCI, 128 reference participants; 689 years; 36% F; Mini-Mental State Examination 282), we assessed cognitive functioning with a comprehensive test battery. Test scores were transformed into z-scores. Compound z-scores were constructed for: memory, language, attention/psychomotor speed, executive functioning, and global cognitive functioning. We rated cognitive domains as impaired when z-scoreResults-Age, sex, and education adjusted global cognitive functioning z-score was lower in patients with COD (beta [SE]=-0.46 [0.10], PConclusions-A substantial part of patients with HF and COD had cognitive impairment, which warrants vigilance for the occurrence of cognitive impairment. These results underline the importance of an integrative approach in medicine in patients presenting with disorders in the heart-brain axis.
KW - brain
KW - cerebral small vessel diseases
KW - cognitive impairment
KW - dementia
KW - heart failure
KW - ASYMPTOMATIC CAROTID STENOSIS
KW - PARTICIPANTS AGED 24-81
KW - PULSE-WAVE VELOCITY
KW - NORMATIVE DATA
KW - ARTERY OCCLUSION
KW - DEMENTIA
KW - EDUCATION
KW - DECLINE
KW - PERFORMANCE
KW - PRESSURE
U2 - 10.1161/STROKEAHA.119.026031
DO - 10.1161/STROKEAHA.119.026031
M3 - Article
C2 - 31684846
SN - 0039-2499
VL - 50
SP - 3369
EP - 3375
JO - Stroke
JF - Stroke
IS - 12
ER -