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. 2012 Jan;2(1):88-98.
doi: 10.1159/000343222. Epub 2012 Oct 25.

Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure

Michael L Alosco  1 , Mary Beth Spitznagel, Naftali Raz, Ronald Cohen, Lawrence H Sweet, Lisa H Colbert, Richard Josephson, Manfred van Dulmen, Joel Hughes, Jim Rosneck, John Gunstad
Affiliations

Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure

Michael L Alosco et al. Cerebrovasc Dis Extra. 2012 Jan.

Abstract

Background: Cerebral hypoperfusion accompanies heart failure (HF) and is associated with reduced cognitive performance. Obesity is prevalent in persons with HF and is also a likely contributor to cognitive function, as it has been independently linked to cognitive impairment in healthy individuals. The current study examined the association between obesity and cognitive performance among older adults with HF and whether obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment.

Methods: Patients with HF (n = 99, 67.46 ± 11.36 years of age) completed neuropsychological testing and impedance cardiography. Cerebral blood flow velocity (CBF-V) measured by transcranial Doppler sonography quantified cerebral perfusion and body mass index (BMI) operationalized obesity.

Results: A hierarchical regression analysis showed that lower CBF-V was associated with reduced performance on tests of attention/executive function and memory. Elevated BMI was independently associated with reduced attention/executive function and language test performance. Notably, a significant interaction between CBF-V and BMI indicated that a combination of hypoperfusion and high BMI has an especially adverse influence on attention/executive function in HF patients.

Conclusions: The current findings suggest that cerebral hypoperfusion and obesity interact to impair cognitive performance in persons with HF. These results may have important clinical implications, as HF patients who are at high risk for cerebral hypoperfusion may benefit from weight reduction.

Keywords: Body mass index; Cerebral perfusion; Cognitive function; Heart failure; Obesity.

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Figures

Fig. 1
Fig. 1
The interactive effect of cerebral hypoperfusion and elevated BMI on attention/executive function among older adults with HF. Higher scores on the x-axis are reflective of elevated BMI and higher scores on the y-axis represent better test performance.
See this image and copyright information in PMC

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