Associations Between Ankle-Brachial Index and Cognitive Function: Results From the Lifestyle Interventions and Independence for Elders Trial
Mark A Espeland, Anne B Newman, Kaycee Sink, Thomas M Gill, Abby C King, Michael E Miller, Jack Guralnik, Jeff Katula, Timothy Church, Todd Manini, Kieran F Reid, Mary M McDermott, LIFE Study Group, Marco Pahor, Jack M Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E Miller, Mark A Espeland, Walter T Ambrosius, William Applegate, Daniel P Beavers, Robert P Byington, Delilah Cook, Curt D Furberg, Lea N Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, W Jack Rejeski, Jeffrey A Katula, Peter H Brubaker, Shannon L Mihalko, Janine M Jennings, Evan C Hadley, Sergei Romashkan, Denise E Bonds, Kushang V Patel, Mary M McDermott, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S Church, Steven N Blair, Valerie H Myers, Ron Monce, Nathan E Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K Millet, Catrine Tudor-Locke, Ben P Butitta, Sheletta G Donatto, Shannon H Cocreham, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Leslie A Pruitt, Veronica Yank, Kathy Berra, Carol Bell, Rosita M Thiessen, Kate P Youngman, Selene B Virgen, Eric Maldonado, Kristina N Tarin, Heather Klaftenegger, Carolyn A Prosak, Ines Campero, Dulce M Garcia, José Soto, Linda Chio, David Hoskins, Roger A Fielding, Miriam E Nelson, Sara C Folta, Edward M Phillips, Christine K Liu, Erica C McDavitt, Kieran F Reid, Won S Kim, Vince E Beard, Todd M Manini, Marco Pahor, Stephen D Anton, Susan Nayfield, Thomas W Buford, Michael Marsiske, Bhanuprasad D Sandesara, Jeffrey D Knaggs, Megan S Lorow, William C Marena, Irina Korytov, Holly L Morris, Margo Fitch, Floris F Singletary, Jackie Causer, Katie A Radcliff, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Nancy W Glynn, Oscar Lopez, Neelesh K Nadkarni, Kathy Williams, Mark A Newman, George Grove, Janet T Bonk, Jennifer Rush, Piera Kost, Diane G Ives, Stephen B Kritchevsky, Anthony P Marsh, Tina E Brinkley, Jamehl S Demons, Kaycee M Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Rekeneire, Joanne M McGloin, Karen C Wu, Denise M Shepard, Barbara Fennelly, Lynne P Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N Halpin, Matthew J Brennan, Julie A Bugaj, Maria A Zenoni, Bridget M Mignosa, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L Chupp, Gail M Flynn, Thomas M Gill, John L Hankinson, Carlos A Vaz Fragoso, Erik J Groessl, Robert M Kaplan, Mark A Espeland, Anne B Newman, Kaycee Sink, Thomas M Gill, Abby C King, Michael E Miller, Jack Guralnik, Jeff Katula, Timothy Church, Todd Manini, Kieran F Reid, Mary M McDermott, LIFE Study Group, Marco Pahor, Jack M Guralnik, Christiaan Leeuwenburgh, Connie Caudle, Lauren Crump, Latonia Holmes, Jocelyn Lee, Ching-ju Lu, Michael E Miller, Mark A Espeland, Walter T Ambrosius, William Applegate, Daniel P Beavers, Robert P Byington, Delilah Cook, Curt D Furberg, Lea N Harvin, Leora Henkin, John Hepler, Fang-Chi Hsu, Laura Lovato, Wesley Roberson, Julia Rushing, Scott Rushing, Cynthia L Stowe, Michael P Walkup, Don Hire, W Jack Rejeski, Jeffrey A Katula, Peter H Brubaker, Shannon L Mihalko, Janine M Jennings, Evan C Hadley, Sergei Romashkan, Denise E Bonds, Kushang V Patel, Mary M McDermott, Bonnie Spring, Joshua Hauser, Diana Kerwin, Kathryn Domanchuk, Rex Graff, Alvito Rego, Timothy S Church, Steven N Blair, Valerie H Myers, Ron Monce, Nathan E Britt, Melissa Nauta Harris, Ami Parks McGucken, Ruben Rodarte, Heidi K Millet, Catrine Tudor-Locke, Ben P Butitta, Sheletta G Donatto, Shannon H Cocreham, Abby C King, Cynthia M Castro, William L Haskell, Randall S Stafford, Leslie A Pruitt, Veronica Yank, Kathy Berra, Carol Bell, Rosita M Thiessen, Kate P Youngman, Selene B Virgen, Eric Maldonado, Kristina N Tarin, Heather Klaftenegger, Carolyn A Prosak, Ines Campero, Dulce M Garcia, José Soto, Linda Chio, David Hoskins, Roger A Fielding, Miriam E Nelson, Sara C Folta, Edward M Phillips, Christine K Liu, Erica C McDavitt, Kieran F Reid, Won S Kim, Vince E Beard, Todd M Manini, Marco Pahor, Stephen D Anton, Susan Nayfield, Thomas W Buford, Michael Marsiske, Bhanuprasad D Sandesara, Jeffrey D Knaggs, Megan S Lorow, William C Marena, Irina Korytov, Holly L Morris, Margo Fitch, Floris F Singletary, Jackie Causer, Katie A Radcliff, Anne B Newman, Stephanie A Studenski, Bret H Goodpaster, Nancy W Glynn, Oscar Lopez, Neelesh K Nadkarni, Kathy Williams, Mark A Newman, George Grove, Janet T Bonk, Jennifer Rush, Piera Kost, Diane G Ives, Stephen B Kritchevsky, Anthony P Marsh, Tina E Brinkley, Jamehl S Demons, Kaycee M Sink, Kimberly Kennedy, Rachel Shertzer-Skinner, Abbie Wrights, Rose Fries, Deborah Barr, Thomas M Gill, Robert S Axtell, Susan S Kashaf, Nathalie de Rekeneire, Joanne M McGloin, Karen C Wu, Denise M Shepard, Barbara Fennelly, Lynne P Iannone, Raeleen Mautner, Theresa Sweeney Barnett, Sean N Halpin, Matthew J Brennan, Julie A Bugaj, Maria A Zenoni, Bridget M Mignosa, Jeff Williamson, Kaycee M Sink, Hugh C Hendrie, Stephen R Rapp, Joe Verghese, Nancy Woolard, Mark Espeland, Janine Jennings, Carl J Pepine, Mario Ariet, Eileen Handberg, Daniel Deluca, James Hill, Anita Szady, Geoffrey L Chupp, Gail M Flynn, Thomas M Gill, John L Hankinson, Carlos A Vaz Fragoso, Erik J Groessl, Robert M Kaplan
Abstract
Objective: The objective of this study was to evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function.
Design: Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial).
Setting: Eight US academic centers.
Participants: A total of 1601 adults ages 70-89 years, sedentary, without dementia, and with functional limitations.
Measurements: Baseline ABI and interviewer- and computer-administered cognitive function assessments were obtained. These assessments were used to compare a physical activity intervention with a health education control. Cognitive function was reassessed 24 months later (interviewer-administered) and 18 or 30 months later (computer-administered) and central adjudication was used to classify individuals as having mild cognitive impairment, probable dementia, or neither.
Results: Lower ABI had a modest independent association with poorer cognitive functioning at baseline (partial r = 0.09; P < .001). Although lower baseline ABI was not associated with overall changes in cognitive function test scores, it was associated with higher odds for 2-year progression to a composite of either mild cognitive impairment or probable dementia (odds ratio 2.60 per unit lower ABI; 95% confidence interval 1.06-6.37). Across 2 years, changes in ABI were not associated with changes in cognitive function.
Conclusion: In an older cohort sedentary individuals with dementia and with functional limitations, lower baseline ABI was independently correlated with cognitive function and associated with greater 2-year risk for progression to mild cognitive impairment or probable dementia.
Trial registration: ClinicalTrials.gov NCT01072500.
Keywords: Cognitive function; ankle-brachial index; dementia; peripheral artery disease.
Conflict of interest statement
CONFLICT OF INTEREST STATEMENT
Conflicts of Interest: None.
Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
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Source: PubMed