Low Ankle-Brachial Index Relates to Alzheimer-Signature Cerebral Glucose Metabolism in Cognitively Impaired Older Adults.
Seok Woo Moon, Min Soo Byun, Dahyun Yi, Min Jung Kim, Joon Hyung Jung, Nayeong Kong, Gijung Jung, Hyejin Ahn, Jun-Young Lee, Koung Mi Kang, Chul-Ho Sohn, Yu Kyeong Kim, Dong Young Lee, KBASE Research Group
Author Information
Seok Woo Moon: Department of Neuropsychiatry & Research Institute of Medical Science, Konkuk University School of Medicine, Chungju, Republic of Korea.
Min Soo Byun: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Dahyun Yi: Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea.
Min Jung Kim: Department of Psychiatry, Eulji University Nowon Eulji Medical Center, Seoul, Republic of Korea.
Joon Hyung Jung: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Nayeong Kong: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Gijung Jung: Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea.
Hyejin Ahn: Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea.
Jun-Young Lee: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
Koung Mi Kang: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Chul-Ho Sohn: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Yu Kyeong Kim: Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
Dong Young Lee: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
BACKGROUND: Ankle-brachial index (ABI), an indicator of atherosclerosis or arterial stiffness, has been associated with Alzheimer's disease (AD) dementia and related cognitive impairment. Nevertheless, only limited information is available regarding its contribution to brain alterations leading to cognitive decline in late-life. OBJECTIVE: We aimed to investigate the relationship of ABI with in vivo AD pathologies and cerebrovascular injury in cognitively impaired older adults. METHODS: Total 127 cognitively impaired (70 mild cognitive impairment and 57 AD dementia) individuals, who participated in an ongoing prospective cohort study, were included. All participants underwent comprehensive clinical and neuropsychological assessment, ABI measurement, apolipoprotein E (APOE) ɛ4 genotyping, and multi-modal brain imaging including [11C] Pittsburgh Compound B (PiB)-positron emission tomography (PET) and [18F] fludeoxyglucose (FDG)-PET, and MRI. RESULTS: General linear model analysis showed significant relationship between ABI strata (low ABI: <1.00, normal ABI: 1.00-1.29, and high ABI: ≥1.30) and AD-signature region cerebral glucose metabolism (AD-CM), even after controlling age, sex, clinical dementia rating-sum of box, and APOE ɛ4 positivity (p = 0.029). Post hoc comparison revealed that low ABI had significantly lower AD-CM than middle and high ABI, while no difference of AD-CM was found between middle and high ABI. There was no significant difference of global Aβ deposition, AD-signature region cortical thickness, and white matter hyperintensity volume between the three ABI strata. CONCLUSION: Our findings suggest that lower ABI, likely related to atherosclerosis, may contribute to the aggravation of AD-related regional neurodegeneration in cognitively impaired older adults.
