A low ankle-brachial index is associated with cognitive impairment: The APAC study

Anxin Wang; Ruixuan Jiang; Zhaoping Su; Jiaokun Jia; Ning Zhang; Jianwei Wu; Shengyun Chen; Xingquan Zhao

doi:10.1016/j.atherosclerosis.2016.11.005

A low ankle-brachial index is associated with cognitive impairment: The APAC study

Atherosclerosis. 2016 Dec:255:90-95. doi: 10.1016/j.atherosclerosis.2016.11.005. Epub 2016 Nov 3.

Authors

Anxin Wang¹, Ruixuan Jiang², Zhaoping Su³, Jiaokun Jia², Ning Zhang², Jianwei Wu², Shengyun Chen⁴, Xingquan Zhao⁵

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100050, China; Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
² Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China.
³ Department of Epidemiology and Health Statistics, Academy of Public Health and Management, Weifang Medical University, Weifang, China.
⁴ Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China. Electronic address: [email protected].
⁵ Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100050, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100050, China. Electronic address: [email protected].

PMID: 27835743
DOI: 10.1016/j.atherosclerosis.2016.11.005

Abstract

Background and aims: Given the recognized links between atherosclerosis and cognitive impairment, the aim of this study was to examine the association between the ankle-brachial index (ABI) and cognitive impairment in a cross-sectional setting of a Chinese population.

Methods: Participants (n = 3,048, aged ≥40 years, 1727 men and 1321 women) were recruited from the ongoing community-based Asymptomatic Polyvascular Abnormalities Community Study. ABI was measured and a low ABI was defined as <0.9. Cognition status was evaluated via the Mini-Mental Status Exam. Multivariate logistic regression models and linear regression models were used to assess the association between ABI and cognitive impairment.

Results: A low ABI was associated with cognitive impairment (odds ratio, OR = 1.983; 95% confidence interval, CI: 1.150-3.419), independent of the potential confounders. In addition, a decreasing ABI (per standard deviation) was significantly associated with cognitive impairment in fully adjusted models (OR = 1.156; CI: 1.013-1.319) and with a significant trend of decreasing MMSE scores (β = 0.703, 95% CI 0.189-1.218, p = 0.0074). Furthermore, the odds of a low ABI associated with cognitive impairment in participants without hypertension and participants with diabetes were 4.924 (CI: 1.860-13.035) and 6.393 (CI: 2.431-16.810), respectively.

Conclusions: A low ABI is associated with cognitive impairment, especially in non-hypertensive and diabetic patients.

Keywords: Atherosclerosis; Cognition; Community-based; Peripheral arterial disease.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Ankle Brachial Index*
Chi-Square Distribution
China / epidemiology
Cognition*
Cognitive Dysfunction / diagnosis
Cognitive Dysfunction / epidemiology
Cognitive Dysfunction / psychology*
Comorbidity
Cross-Sectional Studies
Diabetes Mellitus / epidemiology
Female
Humans
Hypertension / epidemiology
Hypertension / physiopathology
Linear Models
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Peripheral Arterial Disease / diagnosis*
Peripheral Arterial Disease / epidemiology
Peripheral Arterial Disease / physiopathology
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors