Abstract
Atherosclerosis is an important risk factor for cognitive decline. This study aimed to investigate the relationship of ankle-brachial pressure index (ABI) and brachial-ankle pulse wave velocity (baPWV) with cognitive function in patients with lacunar infarction. We included records of consecutive patients with their first-ever acute stroke and a diagnosis of lacunar infarction through magnetic resonance imaging (MRI) from July 1, 2011 to December 31, 2018. We excluded patients diagnosed with dementia, including strategic single-infarct dementia, before or after stroke onset. Moreover, we excluded patients with one or more microbleeds, severe white matter lesions, or severe medial temporal atrophy on MRI. For ABI, we used the lower ankle side and divided the results into ABI < 1.0 and ABI ≥ 1.0. For baPWV, we used the higher ankle side and divided the results into two groups based on the median value of the participants. We analyzed 176 patients with stroke (age 72.5 ± 11.4 years, 67 females). The median score on the Mini-Mental State Examination (MMSE) was 27. The number of patients with ABI < 1.0 was 19 (10.8%). Univariate analysis revealed that the MMSE score was associated with age, body mass index, education, chronic kidney disease, periventricular hyperintensity, and ABI < 1.0 (p < 0.10), but not baPWV. Multivariate analysis revealed that body mass index (p = 0.039) and ABI < 1.0 (p = 0.015) were independently associated with the MMSE score. For patients with lacunar infarction, a lower ABI, but not a higher PWV, was associated with cognitive decline.
Highlights
In an aging society, cognitive decline, which causes morbidity and mortality, is among the most critical issues with respect to population health, care, and medical economics [1, 2].Lifestyle habits, including vascular risk factors, contribute to stroke and vascular cognitive impairment [3, 4]
We investigated the relationship of ankle-brachial pressure index (ABI) and brachial-ankle pulse wave velocity (baPWV) with cognitive function in patients with firstever lacunar infarction and without cerebral microbleeds (CMBs) and white matter lesions (WMLs)
Data pertaining to systolic and diastolic blood pressure in the four limbs and bilateral ABI and baPWV are shown in S1 Table
Summary
Cognitive decline, which causes morbidity and mortality, is among the most critical issues with respect to population health, care, and medical economics [1, 2].Lifestyle habits, including vascular risk factors, contribute to stroke and vascular cognitive impairment [3, 4]. Vascular disease is an important modifiable risk factor for clinically diagnosed Alzheimer’s dementia and related dementias [5, 6]. Atherosclerosis and cerebral circulation are important factors for cognitive decline.
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