The prevalence of cognitive impairment increases with age. Increases in life expectancy have brought age-associated cognitive decline to the forefront of public health. Although the etiology of cognitive impairment in older adults is multifactorial, cerebral macro- and microvascular dysfunction plays a prominent role. Even so, the relationship of peripheral vascular health to cognitive impairment risk is not clear. Because aging exerts similar vascular changes in the peripheral and cerebral circulation, it may be possible to screen for disruptions of the cerebral vasculature through a proxy assessment of the peripheral vasculature. This approach could be accessible at the population level in the outpatient setting, as it is free from the instrumental requirements needed to directly measure cerebral blood flow.

OSCTR Pilot Investigator Andriy Yabluchanskiy examined the relationship between age-related vascular dysfunction and cognitive performance in a cross-sectional comparison of young (<45 years old, n=31) and aged (>65 years old, n=29) individuals. The groups were controlled for similar sex, ethnicity, BMI and medical comorbidities. A panel of tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to measure cognitive performance. Peripheral vascular health was assessed through microvascular reactivity, arterial macrovascular endothelial function, and vascular stiffness. The aged group displayed significantly impaired vascular health across these domains. The multiple vascular and cognitive measures were reduced into comprehensive vascular health and cognitive impairment indices, using principle component analysis. The vascular health index decreased with age, while the cognitive impairment index increased with age. Further, the vascular health index was inversely correlated with the cognitive impairment index.

Dr. Yabluchanskiy’s findings suggest that less invasive studies of the peripheral vasculature can provide insights to altered cerebrovascular function contributing to age-related cognitive impairment and dementia. Furthermore, the vascular health index may be a useful for identifying patients at risk of cognitive impairment and dementia and monitoring the effects of interventions. These are important steps toward early intervention to reduce the impact of age-related cognitive impairment and dementia.

This project was partially funded by a pilot award to the project PI, Dr. Andriy Yabluchanksiy, and the OSCTR Clinical Resources Core assisted with recruiting study participants and conducting study visits. In addition, as a pilot PI, Dr. Yabluchanskiy received mentoring, IRB assistance, and access to additional professional development support through the OSCTR Scholars Program.

Reference: Csipo T, Lipecz A, Fulop GA, Hand RA, Ngo BN, Dzialendzik M, et al. Age-related Decline in Peripheral Vascular Health Predicts Cognitive Impairment. Geroscience. 2019 Apr;41(2):125-136. -Summary by Matt Slieff