Cognitive function in patients with peripheral artery disease: a prospective single-center cohort study

The aim of the present study was to examine the association between cardiovascular comorbidities and risk factors, and cognitive function in peripheral artery disease (PAD) patients, as well as to determine the influence of cognitive function on cardiovascular outcome in a two-year follow-up.

The cognitive function of 104 PAD patients was assessed using the mini-mental test (MMSE). Ankle Brachial Index (ABI), Fontaine stage, PAD localization, cardiovascular risk factors and comorbidities were taken from the electronic patient charts. A multiple logistic regression model, which included myocardial infarction (MI), stroke/transient ischemic attack (TIA), diabetes mellitus (DM), coronary heart disease (CHD) and smoking was performed to compare patients with and without cognitive impairment. All study participants were followed for two years in order to evaluate their cardiovascular outcome, mortality and revascularisation rate.

There was no significant difference in mini-mental state between asymptomatic and symptomatic PAD patients. ABI and PAD localization was not related to cognitive function. However, pre-existing stroke, TIA, coronary artery disease (CAD) or DM were associated with a lower MMSE score. When MMSE was dichotomized in ≤27 and >27 points, the presence of CAD, history of cerebrovascular events and DM was associated with a MMSE ≤27 in multivariate analysis. There was no association between MMSE and cardiovascular event rate.

PAD patients with CAD, stroke, TIA or DM have worse cognitive function than those without these factors. There was no evidence that cognitve function influenced cardiovascular outcome.