A low ankle-brachial index is associated with cognitive impairment: The APAC study

Given the recognized links between atherosclerosis and cognitive impairment, the aim of this study was to examine the association between the ankle-brachial index (ABI) and cognitive impairment in a cross-sectional setting of a Chinese population.Participants (n = 3,048, aged ≥40 years, 1727 men and 1321 women) were recruited from the ongoing community-based Asymptomatic Polyvascular Abnormalities Community Study. ABI was measured and a low ABI was defined as <0.9. Cognition status was evaluated via the Mini-Mental Status Exam. Multivariate logistic regression models and linear regression models were used to assess the association between ABI and cognitive impairment.A low ABI was associated with cognitive impairment (odds ratio, OR = 1.983; 95% confidence interval, CI: 1.150-3.419), independent of the potential confounders. In addition, a decreasing ABI (per standard deviation) was significantly associated with cognitive impairment in fully adjusted models (OR = 1.156; CI: 1.013-1.319) and with a significant trend of decreasing MMSE scores (β = 0.703, 95% CI 0.189-1.218, p = 0.0074). Furthermore, the odds of a low ABI associated with cognitive impairment in participants without hypertension and participants with diabetes were 4.924 (CI: 1.860-13.035) and 6.393 (CI: 2.431-16.810), respectively.A low ABI is associated with cognitive impairment, especially in non-hypertensive and diabetic patients.