September 1, 2015Open Access
Microvascular and Macrovascular Abnormalities and Cognitive and Physical Function in Older Adults: Cardiovascular Health Study
Resultado clave
High microvascular and macrovascular burden in older adults was associated with worse cognitive (mean score difference -0.30; 95% CI -0.37 to -0.24) and physical function compared to low burden.
Diseño del estudio
Tipo
Cross-Sectional (n=2,452)
PICO estructurado
Are high microvascular and macrovascular burdens associated with worse cognitive and physical function in older adults?
P
Población
2,452 community-dwelling older adults (mean age 79.5) with available data on ≥3 of 5 microvascular abnormalities (brain, retina, kidney) and ≥3 of 6 macrovascular abnormalities (brain, carotid artery, heart, peripheral artery)
I
Intervención
High microvascular and macrovascular burden
C
Comparador
Low microvascular and macrovascular burden
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Resultado
Standardized composite scores derived from three cognitive tests (Modified Mini-Mental State Examination, Digit-Symbol Substitution Test, Trail-Making Test) and three physical tests (gait speed, grip strength, 5-time sit to stand)
High microvascular and macrovascular burden are independently associated with worse cognitive and physical function in older adults.
Resultado numérico
Estimación del efecto: mean score difference -0.30 (cognitive), -0.32 (physical) (95% CI -0.37 to -0.24 (cognitive), -0.38 to -0.26 (physical))
Resumen
OBJECTIVES: To evaluate and compare the associations between microvascular and macrovascular abnormalities and cognitive and physical function DESIGN: Cross-sectional analysis of the Cardiovascular Health Study (1998-1999). SETTING: Community. PARTICIPANTS: 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). MEASUREMENTS: 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) RESULTS: 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. CONCLUSION: 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.
Cite This Study
Kim et al. (Tue,) conducted a cross-sectional in Microvascular and macrovascular abnormalities (n=2,452). High microvascular and macrovascular burden vs. Low microvascular and macrovascular burden was evaluated on Cognitive and physical function composite scores (mean score difference -0.30 (cognitive), -0.32 (physical), 95% CI -0.37 to -0.24 (cognitive), -0.38 to -0.26 (physical)). High microvascular and macrovascular burden in older adults was associated with worse cognitive (mean score difference -0.30; 95% CI -0.37 to -0.24) and physical function compared to low burden.