Systemic hypoperfusion is associated with executive dysfunction in geriatric cardiac patients

Abstract

The present study examines the relationship between systemic hypoperfusion via cardiac output (CO) and neuropsychological performances emphasizing executive function in an aging cohort. Geriatric outpatients with treated, stable cardiovascular disease (CVD) and no history of neurological illness (n=72, ages 56-85) were administered cognitive measures with an emphasis on executive functioning. Echocardiogram findings were used to stratify participants into two groups: low CO (<4.0 L/min) and normal CO (> o r=4.0 L/min). Between-group comparisons were made using ANCOVAs adjusting for systolic blood pressure. The low CO group performed significantly worse than the normal CO group on DKEFS Tower Test and DKEFS Trail Making Test. No significant between-group differences were noted for any of the other cognitive indices. Findings suggest that reduced CO is associated with poorer executive functioning among geriatric outpatients with stable CVD, as the cognitive profile emphasizes a relationship between systemic hypoperfusion and problems with sequencing and planning. The executive dysfunction profile may be secondary to reduced blood flow to vulnerable subcortical structures implicated in frontal-subcortical circuitry.

Functional MR Imaging Evidence of Altered Functional Activation in Metabolic Syndrome

“…Support is provided by a growing body of literature documenting that peripheral cardiovascular dysfunction is related to poor cerebrovascular health and diminished cognitive function in older patients with cardiovascular disease. [43][44][45][51][52][53][54][55] Due to the multifaceted nature of MetS, further research is necessary to explore the contributions of frank vascular disease to the observed cognitive taskϪrelated BOLD response changes in midlife. Further exploration of other potential mechanisms such as alterations in cerebral glucose metabolism and inflammation will also be valuable.…”

Vascular health and cognitive function in older adults with cardiovascular disease

“…Medial calcification deposits, elastic breakdown, collagen crosslinking, and intimal-medial thickening confer predominant vascular stiffening 46,15,43,44 , i.e., changes that can hinder the normal ventricular-vascular coupling dynamics and can contribute to progressive impedance and progressive potential for peripheral hypoperfusion 6 . Oxidative stress may compound propensity for endothelial-independent vascular abnormalities 45,46 . Accumulating free radicals with age and disease can interrupt normal smooth muscle vasodilatory mechanisms, i.e., diminishing vasodilatory responses to exogenous as well as endogenous nitrates.…”

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults

“…We hypothesized that GLS would relate to cognition, especially memory13, 14 and executive function,15, 16 known to be most affected by compromised cardiovascular function. We also hypothesized that GLS would have stronger associations with cognition than LVEF.…”