engleski

Assessment Of Beta Stiffness Index In Patients With Memory Problems : A Pilot Study

Recent studies have indicated that vascular risk f'actors are involved in the pathogenesis of cognitive disorders and dementia. Both VaD and AD, being the most common subtypes of dementia, are associated with cerebrovascular disease and different vascular risk factors. An increased pulse pressure has been associated with the prevalence and severity of cerebral white matter lesions while aortic stiffness was shown to be an independent predictor of stroke in patients with hypertension. Lesions of cerebral microvessels due to cerebral amyloid angiopathy, hyalinosis or microvascular degeneration induce chronic hypoperfusion of the white matter contributing to early expression of the cognitive decline. Measurement of changes of arterial beta stiffness index and circumferential arterial strain (CAS) on carotid arteries as a cerebrovascular model could be used as a screening method for the structural and functional changes of the cerebrovascular tree in patients with memory problems. We studied the association between cognitive function and arterial beta stiffness index in 40 elderly subjects reporting memory problems. Neuropsychological evaluation was performed using MMSE, CDR (Clinical Dementia Rating) and MoCA (Montreal cognitive assessment). Subjects were categorised into three groups according to neuropsychological evaluation: mild cognitively impaired patients (MCI ; CDR => 0, 5 ; n=12), Alzheimer disease (AD ; n= 16) and vascular dementia (VaD ; n=12). Control group consisting of 30 subjects with no subjective or objective memory problems was used for comparison. Carotid arteries were used as a cerebrovascular model in both groups and beta stiffness index as well as CAS were measured, using Aloka SV-5500 with linear probe 5MHz for e-tracing and 13 MHz for morphologic evaluation. After adjustment for age, gender, education level and vascular risk factors, we observed a significant association between cognitive status and both arterial beta stiffness index and CAS (p<0, 005). Arterial beta stiffness index showed positive association with cognitive impairment in patients group, independently of major modifiable vascular risk factors. This method could be used as a non-invasive vascular screening method in patients with memory problems.

beta stiffness; dementia; cognitive function

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