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Reduced cerebral perfusion predicts greater depressive symptoms and cognitive dysfunction at a 1-year follow-up in
Michael L Alosco1, Mary Beth Spitznagel, Ronald Cohen
1Department of Psychology, Kent State University, Kent, OH, USA.
Insights
Reduced cerebral blood flow velocity (CBF-V) in heart failure patients was linked to worse cognitive function and increased depressive symptoms over one year. This suggests cerebral hypoperfusion may impact brain health in heart failure.
Area of Science:
- Cardiology
- Neurology
- Gerontology
Background:
- Heart failure (HF) is frequently associated with cerebral hypoperfusion, potentially leading to neurocognitive deficits.
- Depressive symptoms affect a significant portion of HF patients, with reduced cerebral blood flow being a possible contributing factor.
- The relationship between reduced brain perfusion and the risk of cognitive decline in older adults with HF remains understudied.
Purpose of the Study:
- To investigate the association between cerebral blood flow velocity (CBF-V) and neurocognitive function in patients with heart failure.
- To examine whether reduced CBF-V predicts future cognitive dysfunction and depressive symptomatology in this population.
- To assess changes in CBF-V, cognitive abilities, and depressive symptoms over a 12-month period in individuals with HF.
Main Methods:
- One hundred heart failure patients underwent transcranial Doppler ultrasonography to measure global cerebral blood flow velocity (CBF-V).
- Participants completed a cognitive test battery assessing global cognition, attention/executive function, and memory at baseline and 12-month follow-up.
- Depressive symptomatology was evaluated using the Beck Depression Inventory-II at both time points.
Main Results:
- Cerebral blood flow velocity (CBF-V) demonstrated a decline over the 12-month study period.
- Lower baseline CBF-V was significantly associated with poorer attention/executive function and increased depressive symptoms at 12 months.
- A trend was observed for reduced baseline CBF-V predicting worse memory performance at follow-up, even after adjusting for confounding variables.
Conclusions:
- Cerebral perfusion decreases over time in heart failure patients and is linked to diminished cognitive function and heightened depressive symptoms.
- These findings suggest that cerebral hypoperfusion may play a role in the development of cognitive impairment and depression in heart failure.
- Further longitudinal neuroimaging studies are warranted to elucidate the structural impact of cerebral hypoperfusion on cognitive decline and depression in HF.
Objective:
Cerebral hypoperfusion is common in heart failure (HF) and believed to underlie poor neurocognitive outcomes in this population. Up to 42% of HF patients also exhibit depressive symptomatology that may stem from reduced cerebral blood flow. However, no study has examined this possibility or whether reduced brain perfusion increases risk for future cognitive dysfunction in older adults with HF.
Methods:
One hundred HF patients underwent transcranial Doppler ultrasonagraphy to quantify global cerebral blood flow velocity (CBF-V) and were administered a cognitive test battery to assess global cognition, attention/executive function, and memory abilities. All participants then completed the Beck Depression Inventory-II to assess depressive symptomatology. These procedures were performed at baseline and at 12-month follow-up.
Results:
Repeated measures revealed that CBF-V declined over the 12-month period. Regression analyses showed that reduced baseline CBF-V predicted worse performances in attention/executive function (p < 0.05 for all) and a trend for memory (p = 0.09) in addition to greater depressive symptomatology (p < 0.05) at the 12-month follow-up, even after controlling for baseline factors and medical and demographic variables.
Conclusions:
Cerebral perfusion declined over time and was associated with poorer cognitive function and greater depressive symptoms at a 1-year follow-up in HF. Prospective studies with long-term follow-ups that employ neuroimaging are needed to examine whether cognitive dysfunction and depression in HF stem from the adverse effects of cerebral hypoperfusion on the cerebral structure.
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