Csipo Tamas, Lipecz Agnes, Mukli Peter, Péterfi Anna, Szarvas Zsofia, Ungvari Anna, Alaoui Lamyae El, Sándor Márton, Kállai Attila, Fekete Mónika, Fülöp Gábor Á, Tarantini Stefano, Csiszar Anna, Benyó Zoltán, Sótonyi Péter, Tabak Adam G, Merkely Béla, Yabluchanskiy Andriy, Ungvari Zoltan
Institute of Preventive Medicine and Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Geroscience. 2025 Feb;47(1):1329-1344. doi: 10.1007/s11357-024-01447-y. Epub 2024 Nov 27.
With a growing elderly population in the European Union, age-related diseases associated with unhealthy aging pose increasing public health challenges, including a loss of independence and heightened societal burdens. The Semmelweis Study, a prospective occupational cohort study in Hungary, seeks to identify determinants of unhealthy aging, focusing on the complex relationship between lifestyle, environmental, occupational factors, and the development of chronic age-associated diseases, including age-related vascular cognitive impairment (VCI). The primary objective of this pilot study was to establish a robust, high-throughput assessment methodology to comprehensively evaluate both peripheral and cerebrovascular health to provide a solid foundation for the forthcoming Semmelweis Study framework. The study involved 49 participants aged 23 to 87 years, and it assessed multi-domain cognitive performance through an automated battery of tests (CANTAB). Vascular health was comprehensively evaluated using laser speckle contrast imaging (LSCI), flow-mediated dilation (FMD), static and dynamic retinal vessel analysis (SVA, DVA), and measurements of vascular stiffness. The retinal microvasculature, which closely mirrors the cerebral circulation in anatomy, physiology, and pathophysiology, provided a unique window for examination. Optical imaging through SVA and DVA enables the identification of structural and functional changes in the central nervous system's microcirculation, which are highly relevant to the pathogenesis of VCI. Subsequently, the collected measures were integrated into vascular health indices using principal component analysis (PCA) and the relationship to the age and cognitive status of study participants was explored. These comprehensive vascular health indices demonstrated a correlation not only with age but also with cognitive performance. This methodology holds promise for providing novel insights into the intricate interplay between vascular and cognitive health within the context of the Semmelweis Study.
随着欧盟老年人口的不断增加，与不健康衰老相关的年龄相关性疾病给公共卫生带来了日益严峻的挑战，包括独立性丧失和社会负担加重。塞麦尔维斯研究是匈牙利一项前瞻性职业队列研究，旨在确定不健康衰老的决定因素，重点关注生活方式、环境、职业因素与慢性年龄相关性疾病（包括年龄相关性血管性认知障碍，VCI）发展之间的复杂关系。这项试点研究的主要目标是建立一种强大的、高通量的评估方法，以全面评估外周和脑血管健康，为即将开展的塞麦尔维斯研究框架提供坚实基础。该研究涉及49名年龄在23至87岁之间的参与者，并通过一组自动化测试（CANTAB）评估多领域认知表现。使用激光散斑对比成像（LSCI）、血流介导的血管舒张（FMD）、静态和动态视网膜血管分析（SVA、DVA）以及血管硬度测量等方法对血管健康进行了全面评估。视网膜微血管在解剖学、生理学和病理生理学上与脑循环密切相似，为检查提供了一个独特的窗口。通过SVA和DVA进行的光学成像能够识别中枢神经系统微循环中的结构和功能变化，这些变化与VCI的发病机制高度相关。随后，使用主成分分析（PCA）将收集到的测量数据整合到血管健康指数中，并探讨了其与研究参与者年龄和认知状态的关系。这些综合血管健康指数不仅与年龄相关，还与认知表现相关。这种方法有望为在塞麦尔维斯研究背景下深入了解血管健康与认知健康之间的复杂相互作用提供新的见解。
