Skip to main content
SpringerLink
Log in

Influence of vascular risk factors on executive function among an age-homogeneous elderly cohort

  • Psychiatry and Preclinical Psychiatric Studies - Original Article
  • Published:
Journal of Neural Transmission Aims and scope Submit manuscript

Abstract

The pathogenesis of executive dysfunction in geriatric depression remains uncertain although causal bidirectional relationships with depression have been discussed. Previous studies have described a potential link with ‘vascular depression’. In this study, we investigate the influence of vascular risk factors and magnetic resonance imaging markers of structural brain ageing, such as increasing deep white matter hyperintensities (DWMH), on executive function in an age-homogeneous population-based study cohort. A total of 606 participants of identical age (75.8 years; standard deviation 0.45 years) took part in the baseline investigation of the Vienna Transdanube Ageing (VITA) study. Each participant underwent a full psychometric examination with standardised neuroimaging and clinical chemistry investigations. Participants were re-examined with the same protocol after exactly 30 and 60 months. Data refer to the individuals who completed the examination at baseline. In the ordinal logistic regression, fewer years of education (P < 0.0001), Trail Making Test-A (P < 0.0001), high homocysteine (P = 0.001), and depression (P < 0.0001) were significantly associated with Trail Making Test-B (TMT-B) values. A significant influence of other vascular risk factors, such as lipids, diabetes, and smoking, on executive dysfunction was not observed. A comparison of both lacunes and DWMH with respect to the TMT-B results showed no significant correlation. Our data do not support the notion that vascular pathogenesis might underlie executive dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Alexopoulos GS, Meyers BS, Young RC et al (1997) Vascular depression hypothesis. Arch Gen Psychiatry 54:915–922

    Article  CAS  PubMed  Google Scholar 

  • Allen MD, Owens TE, Fong AK et al (2011) A functional neuroimaging analysis of the Trail Making Test-B: implications for clinical application. Behav Neurol 24:159–171

    Article  PubMed  Google Scholar 

  • American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Amieva H, Jacqmin-Gadda H, Orgogozo JM et al (2005) The 9 year cognitive decline before dementia of the Alzheimer type: a prospective population-based study. Brain 128:1093–1101

    Article  PubMed  Google Scholar 

  • Breteler MMB, van Swieten JC, Bots MI et al (1994) Cerebral while matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam study. Neurology 4:1246–1252

    Article  Google Scholar 

  • Burke WJ, Roccaforte WH, Wengel SP (1991) The short form of the geriatric depression scale: a comparison with the 30-item form. J Geriatr Psychiatry Neurol 4:173–178

    Article  CAS  PubMed  Google Scholar 

  • Cabeza R, Nyberg L (2000) Imaging cognition II: an empirical review of 275 PET and fMRI studies. J Cogn Neurosci 12:1–47

    Article  CAS  PubMed  Google Scholar 

  • Cummings JL (1993) Frontal-subcortical circuits and human behaviour. Arch Neurol 50:873–880

    Article  CAS  PubMed  Google Scholar 

  • Debette S, Seshadri S, Beiser A et al (2011) Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline. Neurology 77:461–468

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • De Leeuw FE, de Croot JC, Oudkerk M et al (1999) A follow up study of blood pressure and cerebral white matter lesions. Ann Neurol 46:827–833

    Article  PubMed  Google Scholar 

  • Elias MF, Beiser A, Wolf PA et al (2000) The preclinical phase of Alzheimer disease: a 22-year prospective study of the Framingham Cohort. Arch Neurol 57:808–813

    Article  CAS  PubMed  Google Scholar 

  • Fassbender K, Mielke O, Bertsch T et al (1999) Homocysteine in cerebral macroangiography and microangiopathy. Lancet 353:1586–1587

    Article  CAS  PubMed  Google Scholar 

  • Fazekas F, Chawluk JB, Alavi A et al (1987) MR signal abnormalities at 1.5 T in Alzheimer`sdementia and normal aging. AJNR 8:421–427

    Google Scholar 

  • Fischer P, Jungwirth S, Krampla W et al (2002) Vienna Transdanube Aging ‘VITA’: study design, recruitment strategies and level of participation. J Neural Transm Suppl 62:105–116

    Article  PubMed  Google Scholar 

  • Fischer P, Krampla W, Mostafaie N et al (2007) VITA study: white matter hyperintensities of vascular and degenerative origin in the elderly. J Neural Trans Suppl 72:181–188

    Article  Google Scholar 

  • Fischer P, Zehetmayer S, Bauer K et al (2006) Relation between vascular risk factors and cognition at age 75. Acta Neurol Scand 114:84–90

    Article  CAS  PubMed  Google Scholar 

  • Frieling H, Röschke B, Kornhuber J et al (2005) Cognitive impairment and its association with homocysteine plasma levels in females with eating disorders-findings from the HEaD-study. J Neural Transm 112:1591–1598

    Article  CAS  PubMed  Google Scholar 

  • Fukudu H, Kitani M (1995) Differences between treated and untreated hypertensive subjects in the extent of periventricular hyperintensities observed on brain MRl. Stroke 26:1593–1597

    Article  Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Hogervorst E, Ribiero HM, Molyneux A et al (2002) Plasma homocysteine levels, cerebrovascular risk factors, and cerebral white matter changes (leukoaraiosis) in patients with Alzheimer disease. Arch Neurol 59:787–793

    Article  PubMed  Google Scholar 

  • Jack CR Jr, Shiung MM, Weigand SD et al (2005) Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI. Neurology 65:1227–1231

    Article  PubMed Central  PubMed  Google Scholar 

  • Johnson KJ, Lui LY, Yaffe K (2007) Executive function, more than global cognition, predicts functional decline and mortality in elderly women. J Gerontol A Biol Sci Med Sci 62:1134–1141

    Article  PubMed Central  PubMed  Google Scholar 

  • Kado D, Selhub J, Seeman T (2001) Plasma total homocysteine levels and cognitive function in older high functioning adults: macarthur studies of successful aging. J Am Geriatr Soc 49:S13

    Google Scholar 

  • Kalmijn S, Lauer LJ, Lindemans J et al (1999) Total homocysteine and cognitive decline in a community-based sample of elderly subjects: the Rotterdam Study. Am J Epidemiol 150:283–289

    Article  CAS  PubMed  Google Scholar 

  • Kortte KB, Horner MD, Windham WK (2002) The trail making test, part B: cognitive flexibility or ability to maintain set? Appl Neuropsychol 9:106–109

    Article  PubMed  Google Scholar 

  • Krishnan KR, Hays JC, Blazer DG (1997) MRI-defined vascular depression. Am J Psychiatry 154:497–501

    Article  CAS  PubMed  Google Scholar 

  • Kuller LH, Lopez OL, Newman A et al (2003) Risk factors for dementia in the Cardiovascular Health Cognition Study. Neuroepidemiology 22:13–22

    Article  PubMed  Google Scholar 

  • Lena SM, Fiocco AJ, Leyenaar JK (2004) The role of cognitive deficits in the development of eating disorders. Neuropsychol Rev 14:99–113

    Article  PubMed  Google Scholar 

  • Liao D, Cooper L, Cai J et al (1996) Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control. The ARIC Study. Atherosclerosis risk in communities study. Stroke 27:2262–2270

    Article  CAS  PubMed  Google Scholar 

  • Lindgren A, Roijer A, Rudling O et al (1994) Cerebral lesions on magnetic resonance imaging, heart disease and vascular risk factors in subjects without stroke : a population-based study. Stroke 23:929–934

    Article  Google Scholar 

  • Longstreth W Jr, Manolio TA, Arnold A et al (1996) Clinical correlates of white matter findings on cranial magnetic resonance aging of 3301 elderly people. The cardiovascular health study. Stroke 27:1274–1282

    Article  PubMed  Google Scholar 

  • Misdraji EL, Gass CS (2010) The Trail Making Test and its neurobehavioral components. J Clin Exp Neuropsychol 32:159–163

    Article  PubMed  Google Scholar 

  • Munshi MN, Hayes M, Iwata I et al (2012) Education and psychological aspects. Which aspects of executive dysfunction influence ability to manage diabetes in older adults? Diabetes Medicine 29:1171–1177

    Article  CAS  Google Scholar 

  • O’ Brien JT, Erkinjuntti T, Reisberg B et al (2003) Vascular cognitive impairment. Lancet 2:89–98

    Article  Google Scholar 

  • Pantoni L (2002) Pathophysiology of age-related cerebral white matter changes. Cerebrovasc Dis 13:7–10

    Article  PubMed  Google Scholar 

  • Pantoni L, Garcia JH, Gutierrez JA (1996) Cerebral white matter is highly vulnerable to ischemia. Stroke 27:1641–1647

    Article  CAS  PubMed  Google Scholar 

  • Plassman BL, Williams JW Jr, Burke JR et al (2010) Systematic review: factors associated with risk for and possible prevention of cognitive decline in later life. Ann Intern Med 153:182–193

    Article  PubMed  Google Scholar 

  • Prins ND, van Dijik EJ, den Heijer T et al (2004) Cerebral white matter lesions and the risk of dementia. Arch Neurol 61:1531–1534

    Article  PubMed  Google Scholar 

  • Rainer MK, Mucke HAM, Zehetmayer S et al (2006) Data from the VITA study do not support the concept of vascular depression. Am J Geriatr Psychiatry 14(6):531–537

    Article  PubMed  Google Scholar 

  • Reitan R (1956) Trail Making Test. Manual for administration, scoring, and interpretation. Indiana University, Indianapolis

    Google Scholar 

  • Reutens S, Sachdev P (2002) Homocysteine in neuropsychiatric disorders of the elderly. Int J Geriatr Psychiatry 17:859–864

    Article  PubMed  Google Scholar 

  • Riggs KM, Spiro A, Tucker K et al (1996) Relations of vitamin B12, vitamin B6, folate, and homocysteine to cognitive performance in the Normative Aging Study. Am J Clin Nutr 63:306–314

    CAS  PubMed  Google Scholar 

  • Sachdev P (2004) Homocysteine, cerebrovascular disease and brain atrophy. J Neurol Sci 226:25–29

    Article  CAS  PubMed  Google Scholar 

  • Sanders ML, Lyness JM, Eberly S et al (2006) Cerebrovascular risk factors, executive dysfunction and depression in older primary care patients. Am J Geriatr Psychiatry 14:145–152

    Article  PubMed  Google Scholar 

  • Sánchez-Cubillo Periáñez JA, Adrover-Roig D et al (2009) Construct validity of the Trail Making Test: role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. J Int Neuropsychol Soc 15:438–450

    Article  PubMed  Google Scholar 

  • Schmidt R, Fazekas F, Kapeller P et al (1999) MRI white matter hypertensities—three year follow-up of the Austrian stroke prevention study. Neurology 53:132–139

    Article  CAS  PubMed  Google Scholar 

  • Schmidt R, Fazekas F, Kleinert G et al (1992) Magnetic resonance imaging signal hyperintensities in the deep and subcortical white matter: acomparative study between stroke patients and normal volunteers. Arch Neurol 49:825–827

    Article  CAS  PubMed  Google Scholar 

  • Seshadri S, Beiser A, Selhub J et al (2002) Plasma homocysteine as a risk factor for dementia and Alzheimer´s disease. N Engl J Med 346:476–483

    Article  CAS  PubMed  Google Scholar 

  • Stein JH, McBride PE (1998) Hyperhomocysteinemia and atherosclerotic vascular disease: pathophysiology, screening and treatment. Arch Intern Med 158:1301–1306

    Article  CAS  PubMed  Google Scholar 

  • Streifler JY, Eliasziw M, Benavente OR et al (2003) Development and progression of leukoaraiosis in patients with brain ischemia and carotid artery disease. Stroke 34:1913–1916

    Article  PubMed  Google Scholar 

  • Stuss DT, Levine B (2002) Adult clinical neuropsychology: lessons from studies of the frontal lobes. Annu Rev Psychol 53:401–433

    Article  PubMed  Google Scholar 

  • Thabit H, Kennelly SM, Bhagarva A et al (2009) Utilization of Frontal Assessment Battery and Executive Interview 25 in assessing for dysexecutive syndrome and its association with diabetes self-care in elderly patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 86:208–212

    Article  CAS  PubMed  Google Scholar 

  • Tombaugh TN (2004) Trail Making Test A and B: normative data stratified by age and education. Achr Clin Neuropsychol 19:203–214

    Article  Google Scholar 

  • Vazzana R, Bandinelli S, Lauretani F et al (2010) Trail making test predicts physical impairment and mortality in older persons. J Am Geriatr Soc 53:410–415

    Google Scholar 

  • Vermeer SE, vanDijik EJ, Koudstaal PJ et al (2002) Homocysteine, silent brain infarcts, and white matter lesions: the Rotterdam scan study. Ann Neurol 51:285–289

    Article  CAS  PubMed  Google Scholar 

  • Voos MC, Custódio EB, Malaquias J Jr (2011) Relationship of executive function and educational status with functional balance in older adults. J Geriatr Phys Ther 34(1):11–18

    PubMed  Google Scholar 

  • Welch GN, Loscalzo L (1998) Homocysteine and atherosclerosis. N Engl J Med 338:1042–1050

    Article  CAS  PubMed  Google Scholar 

  • Ylikoski A, Erkinjuntti T, Raininko R et al (1995) WMH on MRI in the neurologically nondiseased elderly. Analysis of cohorts of consecutive subjects aged 55 to 86 years living at home. Stroke 26:1171–1177

    Article  CAS  PubMed  Google Scholar 

  • Zakzanis KK, Mraz R, Graham SJ (2005) An fMRI study of the trail making test. Neuropsychologia 43:1878–1886

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ludwig Boltzmann Society, L. Boltzmann Institute of Aging Research, Danube Hospital, Langobardenstr. 122, 1220, Vienna, Austria

    Nazanin Sédille-Mostafaie, W. Krampla, W. Krugluger & P. Fischer

  2. Institute for Laboratory Medicine, Danube Hospital, Vienna, Austria

    Nazanin Sédille-Mostafaie & W. Krugluger

  3. Institute for Medical Statistics, Medical University, Vienna, Austria

    S. Zehetmayer

  4. Department of Radiology, Danube Hospital, Vienna, Austria

    W. Krampla

  5. Department of Psychiatry, Danube Hospital, Vienna, Austria

    P. Fischer

Authors
  1. Nazanin Sédille-Mostafaie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Zehetmayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Krampla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. Krugluger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nazanin Sédille-Mostafaie.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sédille-Mostafaie, N., Zehetmayer, S., Krampla, W. et al. Influence of vascular risk factors on executive function among an age-homogeneous elderly cohort. J Neural Transm 122, 1323–1328 (2015). https://doi.org/10.1007/s00702-015-1389-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00702-015-1389-1

Keywords

Search

Navigation