TY - JOUR
T1 - Microvascular Dysfunction Is Associated With Worse Cognitive Performance The Maastricht Study
AU - Rensma, Sytze P.
AU - van Sloten, Thomas T.
AU - Houben, Alfons J. H. M.
AU - Koehler, Sebastian
AU - van Boxtel, Martin P. J.
AU - Berendschot, Tos T. J. M.
AU - Jansen, Jacobus F. A.
AU - Verhey, Frans R. J.
AU - Kroon, Abraham A.
AU - Koster, Annemarie
AU - Backes, Walter H.
AU - Schaper, Nicolaas
AU - Dinant, Geert-Jan
AU - Schalkwijk, Casper G.
AU - Henry, Ronald M. A.
AU - Wolfs, Elze M. L.
AU - van Heumen, Mike J. A.
AU - Schram, Miranda T.
AU - Stehouwer, Coen D. A.
PY - 2020/1
Y1 - 2020/1
N2 - Microvascular dysfunction may be associated with worse cognitive performance. Most previous studies did not adjust for important confounders, evaluated only individual measures of microvascular dysfunction, and showed inconsistent results. We evaluated the association between a comprehensive set of measures of microvascular dysfunction and cognitive performance in the population-based Maastricht Study. We used cross-sectional data including 3011 participants (age 59.5±8.2; 48.9% women; 26.5% type 2 diabetes mellitus [oversampled by design]). Measures of microvascular dysfunction included magnetic resonance imaging features of cerebral small vessel disease, plasma biomarkers of microvascular dysfunction, albuminuria, flicker light-induced retinal arteriolar and venular dilation response and heat-induced skin hyperemia. These measures were summarized into a microvascular dysfunction composite score. Cognitive domains assessed were memory, processing speed, and executive function. A cognitive function score was calculated as the sum of the scores on these 3 cognitive domains. The microvascular dysfunction score was associated with a worse cognitive function score (standardized β, -0.087 [95% CI, -0.127 to -0.047]), independent of age, education level, sex, type 2 diabetes mellitus, smoking, alcohol use, hypertension, total/HDL (high-density lipoprotein) cholesterol ratio, triglycerides, lipid-modifying medication, prior cardiovascular disease, depression and plasma biomarkers of low-grade inflammation. The fully adjusted β-coefficient of the association between the microvascular dysfunction score and the cognitive function score was equivalent to 2 (range, 1-3) years of aging for each SD higher microvascular dysfunction score. The microvascular dysfunction score was associated with worse memory and processing speed but not with worse executive function. The present study shows that microvascular dysfunction is associated with worse cognitive performance.
AB - Microvascular dysfunction may be associated with worse cognitive performance. Most previous studies did not adjust for important confounders, evaluated only individual measures of microvascular dysfunction, and showed inconsistent results. We evaluated the association between a comprehensive set of measures of microvascular dysfunction and cognitive performance in the population-based Maastricht Study. We used cross-sectional data including 3011 participants (age 59.5±8.2; 48.9% women; 26.5% type 2 diabetes mellitus [oversampled by design]). Measures of microvascular dysfunction included magnetic resonance imaging features of cerebral small vessel disease, plasma biomarkers of microvascular dysfunction, albuminuria, flicker light-induced retinal arteriolar and venular dilation response and heat-induced skin hyperemia. These measures were summarized into a microvascular dysfunction composite score. Cognitive domains assessed were memory, processing speed, and executive function. A cognitive function score was calculated as the sum of the scores on these 3 cognitive domains. The microvascular dysfunction score was associated with a worse cognitive function score (standardized β, -0.087 [95% CI, -0.127 to -0.047]), independent of age, education level, sex, type 2 diabetes mellitus, smoking, alcohol use, hypertension, total/HDL (high-density lipoprotein) cholesterol ratio, triglycerides, lipid-modifying medication, prior cardiovascular disease, depression and plasma biomarkers of low-grade inflammation. The fully adjusted β-coefficient of the association between the microvascular dysfunction score and the cognitive function score was equivalent to 2 (range, 1-3) years of aging for each SD higher microvascular dysfunction score. The microvascular dysfunction score was associated with worse memory and processing speed but not with worse executive function. The present study shows that microvascular dysfunction is associated with worse cognitive performance.
KW - blood pressure
KW - cerebral small vessel disease
KW - cognition
KW - dilation
KW - hyperemia
KW - hypertension
KW - microcirculation
KW - SMALL VESSEL DISEASE
KW - WHITE-MATTER HYPERINTENSITIES
KW - GENERAL ELDERLY POPULATION
KW - BDNF VAL66MET POLYMORPHISM
KW - PARTICIPANTS AGED 24-81
KW - LOW-GRADE INFLAMMATION
KW - OFFICE BLOOD-PRESSURE
KW - ENDOTHELIAL DYSFUNCTION
KW - NORMATIVE DATA
KW - DEPRESSIVE SYMPTOMS
U2 - 10.1161/hypertensionaha.119.13023
DO - 10.1161/hypertensionaha.119.13023
M3 - Article
C2 - 31735081
SN - 0194-911X
VL - 75
SP - 237
EP - 245
JO - Hypertension
JF - Hypertension
IS - 1
ER -