Department of Neurology, Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China.
Department of Neurology, Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.
J Alzheimers Dis. 2023;93(3):1111-1124. doi: 10.3233/JAD-221242.
Microvascular dysfunction (MVD) may contribute to cognitive impairment and Alzheimer's disease, but evidence is limited.
To investigate the association of composite and organ-specific MVD burden with mild cognitive impairment (MCI) and cognition among rural-dwelling Chinese older adults.
In this population-based cross-sectional study, we assessed MVD makers using optical coherence tomographic angiography for retinal microvasculature features, brain magnetic resonance imaging scans for cerebral small vessel disease (CSVD), and serum biomarkers for MVD. A composite MVD score was generated from the aforementioned organ-specific parameters. We used a neuropsychological test battery to assess memory, verbal fluency, attention, executive function, and global cognitive function. MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) were diagnosed following the Petersen's criteria. Data was analyzed with the linear and logistic regression models.
Of the 274 dementia-free participants (age≥65 years), 56 were diagnosed with MCI, including 47 with aMCI and 9 with naMCI. A composite MVD score was statistically significantly associated with an odds ratio (OR) of 2.70 (95% confidence interval 1.12-6.53) for MCI and β-coefficient of -0.29 (-0.48, -0.10) for global cognitive score after adjustment for socio-demographics, lifestyle factors, APOE genotype, the Geriatric Depression Scale score, serum inflammatory biomarkers, and cardiovascular comorbidity. A composite score of retinal microvascular morphology was associated with a multivariable-adjusted OR of 1.72 (1.09-2.73) for MCI and multivariable-adjusted β-coefficient of -0.11 (-0.22, -0.01) for global cognitive score. A composite CSVD score was associated with a lower global cognitive score (β= -0.10; -0.17, -0.02).
Microvascular dysfunction, especially in the brain and retina, is associated with MCI and poor cognitive function among rural-dwelling older adults.
微血管功能障碍（MVD）可能导致认知障碍和阿尔茨海默病，但证据有限。
研究复合和器官特异性 MVD 负担与农村居住的中国老年人轻度认知障碍（MCI）和认知之间的关系。
在这项基于人群的横断面研究中，我们使用光学相干断层扫描血管造影评估视网膜微血管特征、脑磁共振成像扫描评估脑小血管疾病（CSVD）以及血清 MVD 标志物来评估 MVD 标志物。从上述器官特异性参数生成复合 MVD 评分。我们使用神经心理学测试套件评估记忆、言语流畅性、注意力、执行功能和整体认知功能。根据彼得森标准诊断 MCI、遗忘型 MCI（aMCI）和非遗忘型 MCI（naMCI）。使用线性和逻辑回归模型进行数据分析。
在 274 名无痴呆参与者（年龄≥65 岁）中，有 56 人被诊断为 MCI，其中 47 人为 aMCI，9 人为 naMCI。复合 MVD 评分与 MCI 的比值比（OR）为 2.70（95%置信区间 1.12-6.53）和整体认知评分的β系数为-0.29（-0.48，-0.10），经调整后包括社会人口统计学因素、生活方式因素、APOE 基因型、老年抑郁量表评分、血清炎症生物标志物和心血管合并症。视网膜微血管形态的复合评分与 MCI 的多变量调整 OR 为 1.72（1.09-2.73）和多变量调整的整体认知评分β系数为-0.11（-0.22，-0.01）。复合 CSVD 评分与整体认知评分较低有关（β=-0.10；-0.17，-0.02）。
微血管功能障碍，尤其是大脑和视网膜的微血管功能障碍，与农村老年人的 MCI 和认知功能下降有关。
