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Cardiovascular Disease Risk Is Associated With Middle Cerebral Artery Blood Flow Velocity in Older Adults

Perdomo, Sophy J., PhD1; Ward, Jaimie, MS1; Liu, Yumei, MD, PhD1; Vidoni, Eric D., PT, PhD2; Sisante, Jason F., PhD1,3; Kirkendoll, Kiersten, DPT1; Burns, Jeffrey M., MD2; Billinger, Sandra A., PT, PhD1

Cardiopulmonary Physical Therapy Journal: March 04, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/CPT.0000000000000110
Research Report: PDF Only

Purpose: The aim of this study was to evaluate the relationship of cardiovascular disease (CVD) on middle cerebral blood flow velocity (MCAv) at rest and during exercise. A secondary aim was to explore the relationship between MCAv and (1) the presence of white matter lesions (WMLs) and (2) cognitive function.

Methods: We recruited individuals who were cognitively normal older adults. Cardiovascular disease risk was assessed by the Pooled Cohort atherosclerotic CVD (ASCVD) risk score. Transcranial Doppler ultrasound measured middle cerebral artery at rest and during a bout of moderate-intensity exercise. We quantified WMLs from magnetic resonance imaging and cognitive function outcomes included executive function, language, processing speed, and attention.

Results: Seventy-two participants 70.1 ± 4.7 years of age completed the study protocol. Atherosclerotic cardiovascular disease risk score was significantly associated with resting and exercise MCAv (P < .01) but not associated with WMLs (P > .468). We observed a significant association between resting and exercise MCAv and language processing (P = .010) but not other cognitive domains.

Conclusions: In cognitively normal older adults, higher ASCVD risk score was associated with blunted resting and exercise MCAv and with lower language processing performance. These results highlight the need for CVD risk management to maintain optimal brain health.

1Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS

2University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Fairway, KS

3Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, KS

Correspondence: Sandra A. Billinger, PT, PhD, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 2002, Kansas City, KS 66160 (

This study was funded in part by K01HD067318 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (S.A.B.) and by the American Heart Association Grant 16GRNT30450008 (S.A.B.). J. F. Sisante was supported in part by T32HD057850 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. This project was supported by the University of Kansas Alzheimer's Disease Center (P30 AG035982) and by an Institutional Clinical and Translational Science Award, NIH/NCATS Grant Number UL1TR000001. Avid Radiopharmaceutical, Eli Lilly and Co., and the NIA (R01 AG043962) provided funds that supported the florbetapir imaging procedure. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or other funding agencies. S. A. Billinger receives support from the Wohlgemuth Faculty Scholar Award. The Georgia Holland Research in Exercise and Cardiovascular Health (REACH) laboratory space was supported by the Georgia Holland Endowment Fund. This study was approved by the University of Kansas Medical Center, approval number STUDY00001444.

The authors declare no conflicts of interest.

© 2019 Cardiovascular and Pulmonary Section, APTA
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