Age-related decline in peripheral vascular health predicts cognitive impairment

Tamas Csipo, Agnes Lipecz, Gabor A. Fulop, Rachel A. Hand, Bich Thy N. Ngo, Mikita Dzialendzik, Stefano Tarantini, Priya Balasubramanian, Tamas Kiss, Valeriya Yabluchanska, Federico Silva-Palacios, Donald L. Courtney, Tarun W. Dasari, Farzaneh Sorond, William E. Sonntag, Anna Csiszar, Zoltan Ungvari, Andriy Yabluchanskiy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Preclinical studies demonstrate that generalized endothelial cell dysfunction and microvascular impairment are potentially reversible causes of age-related vascular cognitive impairment and dementia (VCID). The present study was designed to test the hypothesis that severity of age-related macro- and microvascular dysfunction measured in the peripheral circulation is an independent predictor of cognitive performance in older adults. In this study, we enrolled 63 healthy individuals into young (< 45 years old) and aged (> 65 years old) groups. We used principal component analysis (PCA) to construct a comprehensive peripheral vascular health index (VHI) encompassing peripheral microvascular reactivity, arterial endothelial function, and vascular stiffness, as a marker of aging-induced generalized vascular dysfunction. Peripheral macrovascular and microvascular endothelial function were assessed using flow-mediated dilation (FMD) and laser speckle contrast imaging tests. Pulse waveform analysis was used to evaluate the augmentation index (AIx), a measure of arterial stiffness. Cognitive function was measured using a panel of CANTAB cognitive tests, and PCA was then applied to generate a cognitive impairment index (CII) for each participant. Aged subjects exhibited significantly impaired macrovascular endothelial function (FMD, 5.6 ± 0.7% vs. 8.3 ± 0.6% in young, p = 0.0061), increased arterial stiffness (AIx 29.3 ± 1.8% vs 4.5 ± 2.6% in young, p < 0.0001), and microvascular dysfunction (2.8 ± 0.2 vs 3.4 ± 0.1-fold change of perfusion in young, p = 0.032). VHI showed a significant negative correlation with age (r = − 0.54, p < 0.0001) and CII significantly correlated with age (r = 0.79, p < 0.0001). VHI significantly correlated with the CII (r = − 0.46, p = 0.0003). A decline in peripheral vascular health may reflect generalized vascular dysfunction and predict cognitive impairment in older adults.

Original languageEnglish (US)
Pages (from-to)125-136
Number of pages12
Issue number2
StatePublished - Apr 15 2019


  • Aging
  • Cognitive impairment
  • Endothelial function
  • Microvascular dysfunction
  • VCID

ASJC Scopus subject areas

  • Aging
  • veterinary (miscalleneous)
  • Complementary and alternative medicine
  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine


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