Cardiac hemodynamics are linked with structural and functional features of brain aging: the age, gene/environment
Behnam Sabayan1, Mark A van Buchem1, Sigurdur Sigurdsson2
1Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands (B.S., M.A.B.).
Insights
Reduced cardiac function in older adults is linked to brain aging and cognitive decline. Lower cardiac output and stroke volume correlate with smaller brain volumes and increased risk of cognitive impairment.
Area of Science:
- Cardiology
- Neurology
- Gerontology
Background:
- Advanced heart failure is associated with brain structural and functional changes.
- The impact of declining cardiac function on brain aging in older adults remains unclear.
Purpose of the Study:
- To investigate the association between cardiac hemodynamics and brain aging features in community-dwelling older adults.
Main Methods:
- Utilized data from 931 subjects (mean age 75.9) in the AGES-Reykjavik Study.
- Assessed cardiac hemodynamics using MRI measures: left ventricular stroke volume (LVSV) and cardiac output (CO).
- Analyzed associations between cardiac measures and brain characteristics, including total parenchymal brain volume (TBV) and gray matter volume (GMV).
Main Results:
- Each 10 mL decrease in LVSV correlated with reduced TBV (4.4 mL) and GMV (3.7 mL).
- Each L/min decrease in CO correlated with reduced TBV (3.9 mL) and GMV (3.9 mL).
- Lower LVSV and CO were linked to poorer processing speed and executive function, and a higher risk of mild cognitive impairment or dementia.
Conclusions:
- A gradual decline in cardiac function is associated with brain aging.
- Older individuals with cardiac and cognitive symptoms may have co-existing cardiac and cerebral conditions requiring comprehensive evaluation.
Background:
Advanced heart failure is linked with structural and functional alterations in the brain. It is unclear whether a graded decrease in cardiac function puts older subjects at risk for brain aging. We investigated the association between cardiac hemodynamics and features of brain aging in community-dwelling older subjects.
Methods And Results:
With data from a sub-study (n=931 subjects, mean age 75.9 years, 47.7% male) of the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we investigated the association of MRI measures of cardiac hemodynamics, including left ventricular stroke volume (LVSV) and cardiac output (CO) to brain characteristics. In multivariable analyses, each 10 mL lower LVSV was associated with 4.4 mL (95% CI 1.9 to 6.9) lower total parenchymal brain volume (TBV) and 3.7 mL (95% CI 1.8 to 5.7) lower gray matter volume (GMV). Likewise, each unit (L/min) lower CO was associated with 3.9 mL (95% CI 0.4 to 7.4) lower TBV and 3.9 mL (95% CI 0.4 to 7.4) lower GMV. Lower LVSV was associated with worse performance in processing speed (P=0.043) and executive function (P<0.001). Lower CO was associated with worse performance in processing speed (P=0.015) and executive function (P=0.003). Each 10 mL lower LVSV and each unit lower CO associated with a higher risk of mild cognitive impairment or dementia (odds ratio: 1.24, 95% CI 0.99 to 1.57 and odds ratio: 1.40, 95% CI 0.99 to 2.00, respectively).
Conclusions:
A graded decrease in cardiac functioning is associated with features of brain aging. Older persons with cardiac or cognitive signs and symptoms may have both cardiac and cerebral diseases and should be evaluated accordingly.
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