Ankle-Brachial Index but Neither Intima Media Thickness Nor Coronary Artery Calcification is Associated With Mild Cognitive Impairment

Article type: Research Article

Authors: Weimar, Christian^{a; *} | Winkler, Angela^a | Dlugaj, Martha^a | Lehmann, Nils^b | Hennig, Frauke^c | Bauer, Marcus^d | Kröger, Knut^e | Kälsch, Hagen^d | Mahabadi, Amir-Abass^d | Dragano, Nico^f | Moebus, Susanne^b | Hoffmann, Barbara^{c; g} | Jöckel, Karl-Heinz^b | Erbel, Raimund^d | on behalf the Heinz Nixdorf Recall Study Investigative Group

Affiliations: [a] Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany | [b] Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany | [c] IUF-Leibniz Research Institute for Environmental Medicine | [d] Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Germany | [e] Department of Angiology, Helios Kliniken Krefeld, Germany | [f] Institute for Medical Sociology, Centre for Healthy and Society, Medical Faculty, University of Düsseldorf, Germany | [g] Medical Faculty, Deanery of Medicine, Heinrich-Heine-University of Düsseldorf, Germany

Correspondence: [*] Correspondence to: Prof. Dr. Christian Weimar, UniversityHospital Essen, Department of Neurology, Hufelandstr. 55, 45147 Essen, Germany. Tel.: +49 201 7236504; Fax: +49 201 7236948; [email protected]

Abstract: Background: Several studies have reported an association of atherosclerosis with mild cognitive impairment (MCI) and dementia independent of cardiovascular risk factors. Objective: To compare the cross-sectional association of the ankle-brachial index (ABI), intima media thickness (IMT), and coronary artery calcification (CAC) with MCI and its subtypes, amnestic MCI (aMCI) and non-amnestic MCI (naMCI) in the population-based Heinz Nixdorf Recall cohort study. Methods: 4,086 participants performed a validated brief cognitive assessment at the first follow-up examination (2006–2008). MCI was diagnosed according to previously published criteria. Prevalence ratio (PR) regression models adjusted for age, gender, education, cardiovascular risk factors, and APOE genotype were used to compare the association of the ABI, the CAC-Agatston score and the IMT with MCI and its subtypes. Results: We identified 490 participants with MCI (mean age 66.1 ± 7.8, 46.9 % male, aMCI n = 249, naMCI n = 241) and 1,242 cognitively normal participants. A decreasing ABI (per 0.1) was significantly associated with a higher MCI prevalence in fully adjusted models (PR 1.06; 95% confidence interval (CI) 1.01–1.11), whereas an increasing CAC (log(CAC+1)) or IMT (per 0.1 mm) were not associated after adjustment. A decreasing ABI was also significantly associated with naMCI in fully adjusted models (PR 1.12; CI 1.03–1.21) but not with aMCI. Conclusions: Our data show that the degree of generalized atherosclerosis as measured by the ABI is associated with MCI and with naMCI in a population-based cohort.

Keywords: Aging, ankle-brachial index, atherosclerosis, cognition, coronary artery calcification, intima media thickness, mild cognitive impairment, peripheral arterial disease, population-based studies

DOI: 10.3233/JAD-150218

Journal: Journal of Alzheimer's Disease, vol. 47, no. 2, pp. 433-442, 2015