Microvascular and macrovascular abnormalities and cognitive and physical function in older adults: Cardiovascular health study

Dae Hyun Kim, Francine Grodstein, Anne B. Newman, Paulo H M Chaves, Michelle C. Odden, Ronald Klein, Mark J. Sarnak, Lewis A. Lipsitz

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1886-1893
Number of pages8
JournalJournal of the American Geriatrics Society
Volume63
Issue number9
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

Fingerprint

Cognition
Confidence Intervals
Health
Trail Making Test
Brain
Arteries
Kidney
Cystatin C
Hand Strength
Glomerular Filtration Rate
Short-Term Memory
Carotid Arteries
Ankle
Blood Vessels
Retina
Arm
Cross-Sectional Studies

Keywords

  • cognitive function
  • microvascular disease
  • physical function
  • vascular disease

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Kim, D. H., Grodstein, F., Newman, A. B., Chaves, P. H. M., Odden, M. C., Klein, R., ... Lipsitz, L. A. (2015). Microvascular and macrovascular abnormalities and cognitive and physical function in older adults: Cardiovascular health study. Journal of the American Geriatrics Society, 63(9), 1886-1893. https://doi.org/10.1111/jgs.13594

Microvascular and macrovascular abnormalities and cognitive and physical function in older adults : Cardiovascular health study. / Kim, Dae Hyun; Grodstein, Francine; Newman, Anne B.; Chaves, Paulo H M; Odden, Michelle C.; Klein, Ronald; Sarnak, Mark J.; Lipsitz, Lewis A.

In: Journal of the American Geriatrics Society, Vol. 63, No. 9, 01.09.2015, p. 1886-1893.

Research output: Contribution to journalArticle

Kim, DH, Grodstein, F, Newman, AB, Chaves, PHM, Odden, MC, Klein, R, Sarnak, MJ & Lipsitz, LA 2015, 'Microvascular and macrovascular abnormalities and cognitive and physical function in older adults: Cardiovascular health study', Journal of the American Geriatrics Society, vol. 63, no. 9, pp. 1886-1893. https://doi.org/10.1111/jgs.13594
Kim, Dae Hyun ; Grodstein, Francine ; Newman, Anne B. ; Chaves, Paulo H M ; Odden, Michelle C. ; Klein, Ronald ; Sarnak, Mark J. ; Lipsitz, Lewis A. / Microvascular and macrovascular abnormalities and cognitive and physical function in older adults : Cardiovascular health study. In: Journal of the American Geriatrics Society. 2015 ; Vol. 63, No. 9. pp. 1886-1893.
@article{5e76578d76fc4e94b5acac779bbea708,
title = "Microvascular and macrovascular abnormalities and cognitive and physical function in older adults: Cardiovascular health study",
abstract = "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.",
keywords = "cognitive function, microvascular disease, physical function, vascular disease",
author = "Kim, {Dae Hyun} and Francine Grodstein and Newman, {Anne B.} and Chaves, {Paulo H M} and Odden, {Michelle C.} and Ronald Klein and Sarnak, {Mark J.} and Lipsitz, {Lewis A.}",
year = "2015",
month = "9",
day = "1",
doi = "10.1111/jgs.13594",
language = "English (US)",
volume = "63",
pages = "1886--1893",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Microvascular and macrovascular abnormalities and cognitive and physical function in older adults

T2 - Cardiovascular health study

AU - Kim, Dae Hyun

AU - Grodstein, Francine

AU - Newman, Anne B.

AU - Chaves, Paulo H M

AU - Odden, Michelle C.

AU - Klein, Ronald

AU - Sarnak, Mark J.

AU - Lipsitz, Lewis A.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - 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.

AB - 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.

KW - cognitive function

KW - microvascular disease

KW - physical function

KW - vascular disease

UR - http://www.scopus.com/inward/record.url?scp=84942120417&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942120417&partnerID=8YFLogxK

U2 - 10.1111/jgs.13594

DO - 10.1111/jgs.13594

M3 - Article

C2 - 26338279

AN - SCOPUS:84942120417

VL - 63

SP - 1886

EP - 1893

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 9

ER -