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Updated: Mar 14, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Lower cerebral blood flow is associated with impairment in multiple cognitive domains in Alzheimer's disease
Anna E Leeuwis1, Marije R Benedictus1, Joost P A Kuijer2
1Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
Introduction:
We examined the association between decreased cerebral blood flow (CBF) and cognitive impairment in Alzheimer's disease (AD), mild cognitive impairment (MCI), and subjective cognitive decline (SCD).
Methods:
We included 161 AD, 95 MCI, and 143 SCD patients from the Amsterdam Dementia Cohort. We used 3-T pseudo-continuous arterial spin labeling to estimate whole-brain and regional partial volume-corrected CBF. Neuropsychological tests covered global cognition and five cognitive domains. Associations were investigated using linear regression analyses.
Results:
In the whole sample, reduced overall and regional CBF was associated with impairment in all cognitive domains. We found significant interactions between diagnosis and CBF for language and between diagnosis and parietal CBF for global cognition and executive functioning. Stratification showed that decreased CBF was associated with worse performance in AD patients but not in MCI or SCD.
Discussion:
Our results suggest that CBF may have potential as a functional marker of disease severity.
Insights
Decreased cerebral blood flow (CBF) is linked to cognitive decline in Alzheimer's disease (AD). This association was most pronounced in AD patients, suggesting CBF may indicate disease severity.
Area of Science:
- Neuroimaging
- Neurology
- Cognitive Science
Background:
- Alzheimer's disease (AD), mild cognitive impairment (MCI), and subjective cognitive decline (SCD) are associated with cognitive impairment.
- Cerebral blood flow (CBF) is a critical indicator of brain health.
Purpose of the Study:
- To investigate the relationship between reduced CBF and cognitive impairment across different stages of dementia.
- To determine if CBF can serve as a biomarker for disease severity.
Main Methods:
- 161 AD, 95 MCI, and 143 SCD patients were included.
- 3-T pseudo-continuous arterial spin labeling was used to measure whole-brain and regional CBF.
- Neuropsychological tests assessed global cognition and five domains; linear regression analyzed associations.
Main Results:
- Reduced whole-brain and regional CBF correlated with cognitive impairment across all domains in the total sample.
- Significant interactions between diagnosis and CBF were observed for language, global cognition, and executive functioning.
- Decreased CBF was associated with poorer cognitive performance specifically in AD patients, not in MCI or SCD.
Conclusions:
- Cerebral blood flow (CBF) shows potential as a functional biomarker for assessing Alzheimer's disease severity.
- The findings highlight the differential impact of CBF reduction across the dementia spectrum.
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