Vascular predictors of cognitive decline in patients with mild cognitive impairment

• Published in: Neurobiology of aging 2012-06, Vol.33 (6), p.1127.e1-1127.e9
• Main Authors: Viticchi, Giovanna, Falsetti, Lorenzo, Vernieri, Fabrizio, Altamura, Claudia, Bartolini, Marco, Luzzi, Simona, Provinciali, Leandro, Silvestrini, Mauro
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Alzheimer Disease - diagnosis; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - epidemiology; Alzheimer's disease; Carotid artery; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - pathology; Carotid Intima-Media Thickness - trends; Cognition Disorders - diagnosis; Cognition Disorders - diagnostic imaging; Cognition Disorders - epidemiology; Cognitive ability; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - epidemiology; Dementia disorders; Disease Progression; Female; Follow-Up Studies; Humans; Hypercapnia; Internal Medicine; Male; MCI; Middle Cerebral Artery - diagnostic imaging; Middle Cerebral Artery - pathology; Nervous system; Neurodegenerative diseases; Neurology; Plaque index; Predictive Value of Tests; Prognosis; Regression analysis; Ultrasound
• ISSN: 0197-4580; 1558-1497
• DOI: 10.1016/j.neurobiolaging.2011.11.027

Abstract Our aim in this study was to assess the relationship between the state of cerebral vessels and the risk of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD). We included 117 MCI patients. They underwent an ultrasonographic assessment of common carotid arteries intima-media thickness (IMT) and carotid plaque index. Cerebrovascular reactivity to hypercapnia in the middle cerebral arteries was calculated with the Breath-Holding Index (BHI). After a 12-month follow-up period, neuropsychological examinations demonstrated a progression to dementia in 21 patients. Pathological values of BHI and IMT significantly increased the risk of conversion (BHI: odds ratio, 5.80; 95% confidence interval, 1.83–18.37, p < 0.05; IMT: odds ratio, 3.08; 95% confidence interval, 1.02–9.33; p < 0.05, multinomial logistic regression analysis). Comparison between patients with all normal values and those with the simultaneous alteration of the 2 vascular indexes showed an increase in the risk of conversion from 9% to 33% (ordinal regression analysis). Our findings show that alterations of cerebral vessel functional and anatomic status increase the risk of conversion from MCI to dementia.