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Associations of Microvascular Dysfunction with Mild Cognitive Impairment and Cognitive Function Among Rural-Dwelling
Chunyan Jiang1, Yongxiang Wang1,2,3, Yi Dong1,2,3
1Department of Neurology, Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China.
Background:
Microvascular dysfunction (MVD) may contribute to cognitive impairment and Alzheimer's disease, but evidence is limited.
Objective:
To investigate the association of composite and organ-specific MVD burden with mild cognitive impairment (MCI) and cognition among rural-dwelling Chinese older adults.
Methods:
In this population-based cross-sectional study, we assessed MVD makers using optical coherence tomographic angiography for retinal microvasculature features, brain magnetic resonance imaging scans for cerebral small vessel disease (CSVD), and serum biomarkers for MVD. A composite MVD score was generated from the aforementioned organ-specific parameters. We used a neuropsychological test battery to assess memory, verbal fluency, attention, executive function, and global cognitive function. MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) were diagnosed following the Petersen's criteria. Data was analyzed with the linear and logistic regression models.
Results:
Of the 274 dementia-free participants (age≥65 years), 56 were diagnosed with MCI, including 47 with aMCI and 9 with naMCI. A composite MVD score was statistically significantly associated with an odds ratio (OR) of 2.70 (95% confidence interval 1.12-6.53) for MCI and β-coefficient of -0.29 (-0.48, -0.10) for global cognitive score after adjustment for socio-demographics, lifestyle factors, APOE genotype, the Geriatric Depression Scale score, serum inflammatory biomarkers, and cardiovascular comorbidity. A composite score of retinal microvascular morphology was associated with a multivariable-adjusted OR of 1.72 (1.09-2.73) for MCI and multivariable-adjusted β-coefficient of -0.11 (-0.22, -0.01) for global cognitive score. A composite CSVD score was associated with a lower global cognitive score (β= -0.10; -0.17, -0.02).
Conclusion:
Microvascular dysfunction, especially in the brain and retina, is associated with MCI and poor cognitive function among rural-dwelling older adults.
Insights
Microvascular dysfunction in the brain and retina is linked to mild cognitive impairment (MCI) and lower cognitive function in older Chinese adults. This study highlights the importance of vascular health for maintaining cognitive abilities in aging populations.
Area of Science:
- Neurology
- Gerontology
- Ophthalmology
Background:
- Microvascular dysfunction (MVD) is a potential contributor to cognitive impairment and Alzheimer's disease, though evidence remains limited.
- Investigating the link between MVD and cognitive decline is crucial for understanding aging-related neurological conditions.
Purpose of the Study:
- To examine the association between composite and organ-specific MVD burden and mild cognitive impairment (MCI) in rural Chinese older adults.
- To assess the relationship between MVD and overall cognitive function in this population.
Main Methods:
- A population-based cross-sectional study involving 274 dementia-free participants aged 65 and older.
- MVD markers assessed via optical coherence tomographic angiography (retina), brain MRI (cerebral small vessel disease - CSVD), and serum biomarkers.
- Neuropsychological tests evaluated memory, verbal fluency, attention, executive function, and global cognition; MCI diagnosed using Petersen's criteria.
Main Results:
- A composite MVD score was significantly associated with increased odds of MCI (OR=2.70) and lower global cognitive scores (β=-0.29).
- Retinal microvascular morphology composite score linked to higher MCI odds (OR=1.72) and reduced global cognition (β=-0.11).
- Cerebral small vessel disease (CSVD) composite score correlated with lower global cognitive scores (β=-0.10).
Conclusions:
- Microvascular dysfunction, particularly affecting the brain and retina, is associated with mild cognitive impairment (MCI).
- Findings indicate a significant link between MVD burden and poorer cognitive function in rural-dwelling older adults.
- Vascular health plays a critical role in maintaining cognitive function during aging.
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