Cardiometabolic risk factors predict cerebrovascular health in older adults: results from the Brain in Motion study

Amanda V Tyndall, Laurie Argourd, Tolulope T Sajobi, Margie H Davenport, Scott C Forbes, Stephanie J Gill, Jillian S Parboosingh, Todd J Anderson, Ben J Wilson, Eric E Smith, David B Hogan, Michael D Hill, Marc J Poulin, Amanda V Tyndall, Laurie Argourd, Tolulope T Sajobi, Margie H Davenport, Scott C Forbes, Stephanie J Gill, Jillian S Parboosingh, Todd J Anderson, Ben J Wilson, Eric E Smith, David B Hogan, Michael D Hill, Marc J Poulin

Abstract

Aging and physical inactivity are associated with an increased risk of developing metabolic syndrome (MetS). With the rising prevalence of MetS, it is important to determine the extent to which it affects cerebrovascular health. The primary purpose of this report is to examine the impact of MetS on cerebrovascular health (resting cerebral blood flow (CBF) peak velocity (V¯P), cerebrovascular conductance (CVC), and CBF responses to hypercapnia) in healthy older adults with normal cognition. A secondary goal was to examine the influence of apolipoprotein E (APOE) ε4 expression on these indices. In a sample of 258 healthy men and women older than 53 years, 29.1% met criteria for MetS. MetS, sex, and age were found to be significant predictors of CVC, and V¯P, MetS, and APOE status were significant predictors of V¯P-reactivity, and CVC-reactivity was best predicted by MetS status. After controlling for these factors, participants with MetS demonstrated lower cerebrovascular measures (CVC, V¯P, CVC-reactivity, and V¯P-reactivity) compared to participants without MetS. APOE ε4 carriers had higher V¯P-reactivity than noncarriers. These results provide evidence that cardiometabolic and vascular risk factors clustered together as the MetS predict measures of cerebrovascular health indices in older adults. Higher V¯P-reactivity in APOE ε4 carriers suggests vascular compensation for deleterious effects of this known risk allele for Alzheimer's disease and stroke.

Keywords: Aging; brain health; cerebrovascular regulation; metabolic syndrome.

© 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

Figures

Figure 1
Figure 1
Normality assessment of the cerebrovascular health indices. Histograms display the distribution (frequency, %) of each of the cerebrovascular measure residuals compared to the Normal distribution represented by a solid line. CVC, cerebrovascular conductance (cm/s/mmHg); V¯P, resting cerebral blood flow peak velocity (cm/s); V¯P‐reactivity (cm/s/mmHg), cerebral blood flow reactivity to hypercapnic challenge from +1 torr to +8 torr; CVC‐reactivity (cm/s/mmHg/mmHg), cerebrovascular conductance reactivity to a hypercapnic challenge from +1 torr to +8 torr.
Figure 2
Figure 2
Comparison of the MetS (gray box; n = 75) versus No MetS (open box; n = 183) for the different vascular measurements, corrected for sex. Box plots display the first and third quartiles and whiskers represent the interquartile range. The mean is represented by the diamond within the box and the central horizontal line within the box represents the median of the data. Filled in circles (MetS) or open circles (No MetS) represent data that fall out of the interquartile range. *P < 0.05, **P < 0.01, ***P < 0.001. CVC, cerebrovascular conductance (cm/s/mmHg); V¯P, resting cerebral blood flow peak velocity (cm/s); V¯P‐reactivity (cm/s/mmHg), cerebral blood flow reactivity to hypercapnic challenge from +1 torr to +8 torr; CVC‐reactivity (cm/s/mmHg/mmHg), cerebrovascular conductance reactivity to a hypercapnic challenge from +1 torr to +8 torr.

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