Abstract
<h3>INTRODUCTION AND OBJECTIVES</h3> Despite the shared pathogenesis of peripheral artery disease (PAD) and vascular-related Cognitive Impairment (CI), there is little data on CI in PAD patients. We hypothesized that CI would be common and associated with worsening clinical status in PAD patients. <h3>METHODS</h3> CI screening was prospectively performed for PAD patients undergoing surveillance at a single Veterans Affairs outpatient clinic from 2020-2021. Overall, 125 PAD patients were screened. CI was defined with a validated cut-off of <26 on the Montreal Cognitive Assessment (MOCA) survey. Worsening clinical status was defined as requiring a revascularization and/or worsening wound status within three months from MOCA assessment. Multivariable logistic regression assessed independent risk factors for CI. <h3>RESULTS</h3> Overall, 77 (61%) had CI, 92% representing new diagnoses. CI was associated with increased age (74.4 vs. 71.8 years, p=0.03), Black race (88% vs. 57%, p=0.02), hypertension (66% vs. 31%, p=0.01), prior stroke/TIA (79% vs. 58%,p=0.03), insulin-dependent diabetes (76% vs. 58%,p=0.05), and post-traumatic stress disorder (PTSD) (80% vs. 57%, p=0.04). Overall, 65 (52%) had a worsening clinical status, which was more common in those with CI (61% vs. 38, p=0.01). On multivariable analysis, major risk factors for newly diagnosed CI included worsening clinical status and Black race (Table).Image, table 8 <h3>CONCLUSIONS</h3> Cognitive Impairment is present in most VA-based patients living with PAD and is overwhelmingly underdiagnosed. Patients with worsening clinical status are at high risk, and disparities were noted, as Black race was a significant risk factor. This pilot study suggests CI is a major unrecognized issue in a VA population with PAD, requiring more study to determine its impact on surgical outcomes and how it can be mitigated and incorporated into clinical care.
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