Cognitive function in patients with peripheral artery disease: a prospective single-center cohort study

AIM

The aim of the present study was to examine the association between cardiovascular comorbidities and risk factors, and cognitive function in peripheral artery disease (PAD) patients, as well as to determine the influence of cognitive function on cardiovascular outcome in a two-year follow-up.

METHODS

The cognitive function of 104 PAD patients was assessed using the mini-mental test (MMSE). Ankle Brachial Index (ABI), Fontaine stage, PAD localization, cardiovascular risk factors and comorbidities were taken from the electronic patient charts. A multiple logistic regression model, which included myocardial infarction (MI), stroke/transient ischemic attack (TIA), diabetes mellitus (DM), coronary heart disease (CHD) and smoking was performed to compare patients with and without cognitive impairment. All study participants were followed for two years in order to evaluate their cardiovascular outcome, mortality and revascularisation rate.

RESULTS

There was no significant difference in mini-mental state between asymptomatic and symptomatic PAD patients. ABI and PAD localization was not related to cognitive function. However, pre-existing stroke, TIA, coronary artery disease (CAD) or DM were associated with a lower MMSE score. When MMSE was dichotomized in ≤27 and >27 points, the presence of CAD, history of cerebrovascular events and DM was associated with a MMSE ≤27 in multivariate analysis. There was no association between MMSE and cardiovascular event rate.

CONCLUSION

PAD patients with CAD, stroke, TIA or DM have worse cognitive function than those without these factors. There was no evidence that cognitve function influenced cardiovascular outcome.

Reduction of food intake during pregnancy in rural south India

A common custom in developing countries is reduction of food intake during pregnancy, especially in the last trimester. In the research area in South India, women mentioned that they reduce food intake late in pregnancy. This paper explores whether the reported reduction could be confirmed by quantitative data on food intake; by how much intake was reduced; and whether all women ate less. A group of 186 women in a rural area of Karnataka were followed throughout pregnancy. Most did not achieve the daily food intake recommended by the Indian Council of Medical Research (ICMR), not even that of non-pregnant women. Their average daily energy intake during pregnancy was 1700 kcal. A trend of declining daily energy intake within subjects over the whole period of pregnancy was observed, the biggest change taking place between month 5/6/7 and month 8/9. The major determinant of change in energy intake turned out to be prepregnancy nutritional status, i.e. chronic energy deficiency (CED), measured by body mass index (BMI). Results indicate that women who were better nourished before they became pregnant were more likely to reduce energy intake during pregnancy.

Levels of biogenic amines, their metabolites, and tyrosine hydroxylase activity in the human epileptic temporal cortex

The levels of serotonin (5-HT), 5 hydroxyindoleacetic acid (5-HIAA), dopamine (DA), homovanillic acid (HVA), norepinephrine (NE), and tyrosine hydroxylase (TH) activity were measured in the focus (spiking) and nonfocus (nonspiking) regions of the temporal neocortex of 20 patients with intractable complex partial seizures. The levels of 5-HT, DA, 5-HIAA, and HVA were higher in the focus when compared to the nonfocus. Values for NE and TH activity were not different when focus and nonfocus were compared. The ratios of metabolite to precursor for 5-HT and DA were not significantly different between the focus and the nonfocus, suggesting that the changes observed were the result of a modification in the synthesis and release of these amines. Such changes in the epileptic focus could be caused by altered transsynaptic regulatory processes, which occur as a result of neuronal loss, gliosis, or neuronal sprouting.