Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Oct-Dec;3(4):308-314.
doi: 10.1590/S1980-57642009DN30400008.

Association between cardiovascular disease and dementia

Claudia Kimie Suemoto  1 , Renata Eloah Ferretti  2 , Lea Tenenholz Grinberg  2 , Kátia Cristina de Oliveira  2 , José Marcelo Farfel  1 , Renata Elaine Paraizo Leite  2 , Ricardo Nitrini  3 , Wilson Jacob Filho  1 , Carlos Augusto Pasqualucci  2 ; Brazilian Aging Brain Study Group
Affiliations

Association between cardiovascular disease and dementia

Claudia Kimie Suemoto et al. Dement Neuropsychol. 2009 Oct-Dec.

Abstract
in English, Portuguese

Longitudinal studies have shown association between cardiovascular risk factors and dementia. However, these studies are not capable of detecting asymptomatic cardiovascular alterations and thus may provide erroneous estimates of association. Autopsy studies could be more useful in elucidating these questions. The present clinicopathological study sought to examine the relationship between dementia, cardiovascular risk factors and disease.

Methods: 603 subjects, who underwent autopsy, were classified regarding the presence of dementia, according to post mortem cognitive classification. Demographics, cardiovascular risk factors, and anatomically-proven cardiovascular disease (myocardial hypertrophy, cerebral and carotid atherosclerosis) were compared among cognitively normal persons and individuals with dementia.

Results: Cognitive deficit was associated with advanced age, stroke, physical inactivity and low body mass index (p< 0.05). Circle of Willis atherosclerosis was greater in patients with dementia than in controls on univariate analysis (p=0.01). However, this association lost significance when adjusted by age and gender (p=0.61). Heart failure and anatomopathological cardiac parameters were more severe in the control group than in demented individuals (p< 0.05). Carotid artery atherosclerosis and intima-media thickness were similar in both groups.

Conclusion: Advanced age, stroke, physical inactivity and low body mass index were linked to dementia. Circle of Willis atherosclerosis was associated with dementia only when age was not considered. Our results suggest that cerebral artery atherosclerosis was not directly associated with clinical expression of dementia.

Estudos longitudinais tem mostrado associação entre fatores de risco cardiovascular e demência. Entretanto, estes estudos não são capazes de detectar alterações cardiovasculares assintomáticas e podem, assim, fornecer estimativas de associação errôneas. Estudos de autópsia podem ser mais úteis em elucidar estas questões. O presente estudo clinicopatológico busca examinar a relação entre demência, fatores e doença cardiovascular.

Métodos: 603 sujeitos submetidos à autópsia foram classificados quanto à presença de demência, usando uma classificação cognitiva post-mortem. Dados demográficos, fatores de risco cardiovascular e doença cardiovascular comprovada anatomicamente (hipertrofia miocárdica, aterosclerose cerebral e carotídea) foram comparados entre indivíduos cognitivamente normais e com demência.

Resultados: Déficit cognitivo esteve associado à idade avançada, acidente vascular cerebral, sedentarismo e baixo índice de massa corpórea (p< 0,05). Aterosclerose do polígono de Willis foi maior em pacientes com demência do que em controles na análise univariada (p=0,01). Insuficiência cardíaca e parâmetros anatomopatológicos cardíacos foram mais graves entre o grupo controle que entre os indivíduos dementados (p< 0,05). Aterosclerose de artérias carótidas e espessura íntima-média foram similares entre os grupos.

Conclusão: Idade avançada, acidente vascular cerebral, sedentarismo e baixo índice de massa corpórea estiveram relacionados à demência. Aterosclerose de polígono de Willis esteve associada à demência, somente quando a idade não foi considerada. Nossos resultados sugerem que a aterosclerose de artérias cerebrais não está diretamente relacionada com a expressão clínica de demência.

Keywords: atherosclerosis; cardiomyopathy; carotid artery disease; circle of Willis; dementia.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Cross-sectional image of basilar artery from the circle of Willis. The red tracer is placed on the outer circumference of the artery and the blue inner tracer on the circumference of the lumen. Calibration bar=1 mm.
Figure 2
Figure 2
(A) Right carotid artery and the site of 4 cross-sections: (1) the greatest common carotid artery stenosis; (2) 1 cm below carotid artery bifurcation; (3) 1cm above carotid artery bifurcation; (4) the greatest internal carotid artery stenosis; (B) Histological representation of common carotid artery using Verhoeff’s stain. Red tracer: external elastic lamina; yellow tracer: internal elastic lamina; blue tracer: lumen. (C) Flat section of common carotid artery (Figure 2B). For the calculation of intima media thickness, the intima-media area was divided by the external perimeter (area between red and blue tracer), delimited by external elastic lamina (red). Pext=perimeter of external elastic lamina. Calibration bar=2 mm.
Figure 3
Figure 3
Flow diagram of the participants of the study.
See this image and copyright information in PMC

References

    1. Breteler MM. Vascular risk factors for Alzheimer's disease: an epidemiologic perspective. Neurobiol Aging. 2000;21:153–160. - PubMed
    1. Aguero-Torres H, Kivipelto M, von Strauss E. Rethinking the dementia diagnoses in a population-based study: what is Alzheimer's disease and what is vascular dementia? A study from the Kungsholmen project. Dement Geriatr Cogn Disord. 2006;22:244–249. - PubMed
    1. Ruitenberg A, de Heiker T, Bakker SL. Cerebral hypoperfusion and clinical onset of dementia: the Rotterdam study. Ann Neurol. 2005;57:789–794. - PubMed
    1. Elias MF, Wolf PA, D'Agostinho RB, Cobb J, White LR. Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study. Am J Epidemiol. 1993;138:353–364. - PubMed
    1. Fillit H, Nash DT, Rundek T, Zuckerman A. Cardiovascular risk factors and dementia. Am J Geriatr Pharmacother. 2008;6:100–118. - PubMed

LinkOut - more resources