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Article

Cerebral Vascular Reactivity in Frail Older Adults with Vascular Cognitive Impairment

1
Geriatrics & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
2
Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
3
Epidemiologic and Health Service Research Unit, Aging Area, Mexican Institute of Social Security, National Medical Center Century XXI, Mexico City 06720, Mexico
4
Centre de Recherche Inserm, U1219, F-33076 Bordeaux, France
5
Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, and Weill Cornell Medical College, New York, NY 77030, USA
*
Author to whom correspondence should be addressed.
Brain Sci. 2019, 9(9), 214; https://doi.org/10.3390/brainsci9090214
Received: 21 June 2019 / Revised: 15 August 2019 / Accepted: 19 August 2019 / Published: 24 August 2019
Background: Frailty, a state of increased vulnerability, could play a role in the progression of vascular dementia. We aim to describe the changes in cerebrovascular reactivity of older adults with frailty and vascular-type mild cognitive impairment (MCIv). Methods: This was a cross-sectional study. A comprehensive geriatric assessment, neuropsychological evaluation, and transcranial Doppler ultrasound (TCD) was performed on 180 participants who were allocated into four groups: healthy (n = 74), frail (n = 40), MCIv (n = 35), and mixed (frail + MCIv) (n = 31). ANOVA and Kruskal–Wallis tests were used for the analysis of continuous variables with and without normal distribution. Multinomial logistic regression was constructed to identify associated covariates. Results: Subjects in the mixed group, compared to healthy group, were older (75.0 ± 5.9 vs 70.3 ± 5.9 years; p < 0.001), showed lower education (9.3 ± 6.4 vs 12.2 ± 4.0 years; p = 0.054), greater frequency of diabetes (42% vs 12%; p = 0.005), worse cognitive performance (z = −0.81 ± 0.94), and reduced left medial-cerebral artery cerebrovascular reactivity (0.43 ± 0.42 cm/s). The mixed group was associated with age (odds ratio (OR) 1.16, 95% Confidence Interval (CI) = 1.06–1.27; p < 0.001), diabetes (OR 6.28, 1.81–21.84; p = 0.004), and Geriatric Depression Scale (GDS) score (OR 1.34, 95% CI = 1.09–1.67; p = 0.007). Conclusions: Frailty among older adults was associated with worse cognitive performance, diabetes, and decreased cerebral blood flow. View Full-Text
Keywords: cerebral vascular reactivity; frailty; mild vascular cognitive impairment; neuropsychological tests; older adults; diabetes; transcranial doppler ultrasound cerebral vascular reactivity; frailty; mild vascular cognitive impairment; neuropsychological tests; older adults; diabetes; transcranial doppler ultrasound
MDPI and ACS Style

Aguilar-Navarro, S.G.; Mimenza-Alvarado, A.J.; Corona-Sevilla, I.; Jiménez-Castillo, G.A.; Juárez-Cedillo, T.; Ávila-Funes, J.A.; Román, G.C. Cerebral Vascular Reactivity in Frail Older Adults with Vascular Cognitive Impairment. Brain Sci. 2019, 9, 214. https://doi.org/10.3390/brainsci9090214

AMA Style

Aguilar-Navarro SG, Mimenza-Alvarado AJ, Corona-Sevilla I, Jiménez-Castillo GA, Juárez-Cedillo T, Ávila-Funes JA, Román GC. Cerebral Vascular Reactivity in Frail Older Adults with Vascular Cognitive Impairment. Brain Sciences. 2019; 9(9):214. https://doi.org/10.3390/brainsci9090214

Chicago/Turabian Style

Aguilar-Navarro, Sara G., Alberto J. Mimenza-Alvarado, Isaac Corona-Sevilla, Gilberto A. Jiménez-Castillo, Teresa Juárez-Cedillo, José A. Ávila-Funes, and Gustavo C. Román. 2019. "Cerebral Vascular Reactivity in Frail Older Adults with Vascular Cognitive Impairment" Brain Sciences 9, no. 9: 214. https://doi.org/10.3390/brainsci9090214

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