Diastolic Dysfunction a Common Risk Factor for Cognitive Dec
Diastolic dysfunction, a common and often undiagnosed condition in older individuals, could be contributing to the increasing burden of cognitive decline, a new study suggests. This research is being presented as part of the 2020 American Academy of Neurology Science Highlights.

People with worsening diastolic dysfunction have more white matter hyperintensities on brain imaging and greater difficulty with executive functioning, suggesting that diastolic dysfunction is a common modifiable risk factor for cognitive impairment.

The investigators analyzed data from the Framingham Heart Study Offspring Cohort at examination 8, collected between 2005 and 2008. The study sample included 1438 individuals older than 55 years who had undergone neuropsychological assessment and echocardiographic diastolic measurement. Systolic measurements were normal for the participants, and they did not currently have dementia, stroke, or other neurologic illness.

Results showed that increasing E/E' ratio (the ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity) indicated increasing diastolic dysfunction and was associated with an increase in the incidence of mild cognitive impairment. An increased E/E' ratio was associated with increased executive function impairment in the "similarities" and "phonemic fluency" tasks. Participants with moderate to severe diastolic dysfunction were more impaired with respect to both similarities and phonemic fluency.

The researchers conclude: "As cerebral small vessel disease clinically presents with executive dysfunction, these results align well." They add that replication in additional cohorts and analyses of cognition in treatment trials of diastolic dysfunction are warranted.

Source: https://www.medscape.com/viewarticle/929857#vp_2