Background
Cardiovascular risk factors (CVRFs) and endothelial dysfunction have been associated
independently with poorer neurocognition in middle-aged adults, particularly on tests
of frontal lobe function. However, to our knowledge, no studies have examined markers
of microvascular dysfunction on neurocognition or the potential interaction between
macro- and microvascular biomarkers on neurocognition in middle-aged and older adults
with major depressive disorder (MDD).
Methods
Participants included 202 adults with MDD who were not receiving mental health treatment.
Microvascular endothelial function was assessed using a noninvasive marker of forearm
reactive hyperemia velocity while macrovascular endothelial function was assessed
using flow-mediated dilation (FMD) of the brachial artery. CVRFs were assessed using
the Framingham Stroke Risk Profile and fasting lipid levels. A standardized neurocognitive
assessment battery was used to assess three cognitive domains: executive function,
working memory, and verbal memory.
Results
Greater microvascular dysfunction was associated with poorer neurocognition across
all three domains. Microvascular function continued to predict verbal memory performance
after accounting for background factors and CVRFs. Macro- and microvascular function
interacted to predict working memory performance (F = 4.511, 178, p = 0.035), with a similar nonsignificant association for executive function (F = 2.731, 178, p = 0.095), with moderate associations observed between microvascular function and
neurocognition in the presence of preserved FMD (r61 = 0.40, p = 0.001), but not when FMD was impaired (r63 = −0.05, p = 0.675).
Conclusion
Greater microvascular dysfunction is associated with poorer neurocognition among middle-aged
and older adults. This association was strongest in participants with preserved macrovascular
function.
Key Words
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Article info
Publication history
Published online: July 02, 2018
Accepted:
June 12,
2018
Received in revised form:
June 12,
2018
Received:
April 27,
2018
Identification
Copyright
© 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
