Association of vascular function and cognitive impairment no dementia (CIND)

Date

2011-12-20

Authors

Braslavsky, Anna

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Abstract

Cognitive impairment no dementia (CIND) is conceptualized as a stage of cognitive decline between normal aging and onset of dementia. As persons with CIND are at high risk of developing dementia, efforts to determine early predictors of cognitive decline are warranted to advance both clinical knowledge and practice. Recent evidence suggests persons with CIND may have changes in vascular function compared to non-impaired peers, which may have clinical potential to differentiate those with and without CIND. The purpose of this study is to determine whether vascular functioning, examined both by individual indicators and as an aggregate vascular factor, will be associated with cognitive impairment. It is expected that the individual vascular indicators of hypertension, diabetes, stroke, and heart problems will be related to cognitive status classification, with poorer vascular function being more strongly associated with CIND as compared to the control group. Further, it is expected that examining the aggregate vascular factor in a multivariate approach will be more strongly associated with cognitive status than examining the vascular indicators individually. Data for this study were collected in the Victoria Longitudinal Study (VLS), a large-scale longitudinal, sequential study of community-dwelling older adults in Victoria, British Columbia. Cognitive group status was determined by a distributional approach based on scores on 5 cognitive reference measures. The associations between all vascular factors and cognitive status groups were assessed using chi-square analyses. Univariate analyses were then carried out using ordinal logistic analysis. A multivariate approach using discriminant analysis was then used to determine if cognitive status group membership was associated with vascular function based on linear combinations of vascular indicators. Contrary to expected results, we did not find a significant association between any of the vascular indicators (i.e., blood pressure classification, severity of stroke, severity of heart troubles, and severity of diabetes) and the cognitive status classifications. Further, group membership was not associated with any of the individual vascular markers, or by a multivariate combination of the indicators. Several reasons for this study’s findings include discrepant definitions of cognitive impairment in the literature, sample characteristics (i.e. high education, low base rate of vascular problems), and methodological considerations. Future research objectives should address the longitudinal association of vascular function and cognitive status.

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Keywords

Cognitive impairment no dementia, Vascular function, Cognitive aging, Neuropsychology

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