Association of Vascular Factors and Amnestic Mild Cognitive Impairment: A Comprehensive Approach

Article type: Research Article

Authors: Casado Naranjo, Ignacio^{a; *} | Portilla Cuenca, Juan Carlos^a | Duque de San Juan, Beatriz^a | García, Alfonso Falcón^a | Sevilla, Raúl Romero^a | Serrano Cabrera, Ana^a | Hijón, Carmen Cámara^b | Romero Chala, Silvia^b | Fuentes, José Manuel^c | Ramírez Moreno, José María^d

Affiliations: [a] Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain | [b] Department of Immunology, Hospital San Pedro de Alcántara, Cáceres, Spain | [c] CIBERNED. Department of Biochemistry and Molecular Biology and Genetics, Universidad de Extremadura, Cáceres, Spain | [d] Department of Neurology, Hospital Universitario Infanta Cristina, Badajoz, Spain

Correspondence: [*] Correspondence to: Ignacio Casado Naranjo, MD, Department of Neurology, Hospital San Pedro de Alcántara, Avda Pablo Naranjo s/n, 10001 Cáceres, Spain. Tel.: +34 92621532; Fax: +34 927256202; E-mail: icasadon@gmail.com.

Abstract: Background and objective:Current evidence shows that numerous classic vascular risk factors (VRF) contribute to mild cognitive impairment (MCI), but the effects of emerging VRFs are less well-known. Using a comprehensive approach, we assessed the frequency and strength of association between MCI and classic VRFs, subclinical markers of atherosclerosis (cystatin C, lipoprotein(a), high-sensitivity C-reactive protein, and intima-media thickness) and white matter hyperintensities (WMH). Methods:In this case-control study of consecutive MCI patients and cognitively normal controls, subjects underwent clinical and neuropsychological examinations, laboratory analyses, a carotid duplex scan, and a brain magnetic resonance imaging scan. Results:The study included 105 patients with amnestic MCI (aMCI): 24 with single domain amnestic MCI, 81 with multiple domain amnestic MCI, and 76 controls. Compared to controls, patients with aMCI were significantly older and had higher rates of arterial hypertension, atrial fibrillation, and depression. They also had a larger intima-media thickness and higher load of WMHs, both periventricular (WMHpv) and subcortical (WMHsc). In the adjusted analysis, all variables except WMHsc displayed a significant association with aMCI. Body mass index exerted a protective effect. Conclusions:Our findings suggest a direct association between aMCI and age, hypertension, atrial fibrillation depression, intima-media thickness, and WMHpv. Body mass index has a protective effect on this MCI subtype.

Keywords: Atherosclerosis, carotid intima-media thickness, mild cognitive impairment, vascular risk factors, white matter hyperintensities

DOI: 10.3233/JAD-141770

Journal: Journal of Alzheimer's Disease, vol. 44, no. 2, pp. 695-704, 2015