Microvascular Dysfunction Is Associated With Worse Cognitive Performance: The Maastricht Study.
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.
['Rensma|Sytze P|SP|', 'van Sloten|Thomas T|TT|', 'Houben|Alfons J H M|AJHM|', 'Köhler|Sebastian|S|', 'van Boxtel|Martin P J|MPJ|', 'Berendschot|Tos T J M|TTJM|', 'Jansen|Jacobus F A|JFA|', 'Verhey|Frans R J|FRJ|', 'Kroon|Abraham A|AA|', 'Koster|Annemarie|A|', 'Backes|Walter H|WH|', 'Schaper|Nicolaas|N|', 'Dinant|Geert-Jan|GJ|', 'Schalkwijk|Casper G|CG|', 'Henry|Ronald M A|RMA|', 'Wolfs|Elze M L|EML|', 'van Heumen|Mike J A|MJA|', 'Schram|Miranda T|MT|', 'Stehouwer|Coen D A|CDA|']
D000368:Aged D015415:Biomarkers D059345:Cerebral Small Vessel Diseases D003071:Cognition D060825:Cognitive Dysfunction D003430:Cross-Sectional Studies D019040:E-Selectin D005260:Female D006801:Humans D018799:Intercellular Adhesion Molecule-1 D008279:Magnetic Resonance Imaging D008297:Male D055806:Microvessels D008875:Middle Aged D009483:Neuropsychological Tests D019010:Vascular Cell Adhesion Molecule-1 D014841:von Willebrand Factor
cognition cerebral small vessel disease dilation hyperemia hypertension blood pressure microcirculation