Impaired cerebral hemodynamics and frailty in patients with cardiovascular disease

Miri Lutski, Salo Haratz, Galit Weinstein, Uri Goldbourt, David Tanne

Research output: Contribution to journalArticlepeer-review


Background: Recent studies suggest that impaired cerebrovascular reactivity (CVR), a marker of cerebral microvascular damage, is associated with a higher risk of stroke, cognitive decline, and mortality. We tested whether abnormal cerebrovascular status is associated with late-life frailty among men with pre-existing cardiovascular disease. Methods: A subset of 327 men (mean age at baseline 56.7 ± 6.5 years) who previously participated in the Bezafibrate Infarction Prevention (BIP) trial (1990–1997) and then in the BIP Neurocognitive Study underwent a neurovascular evaluation 14.6 ± 1.9 years after baseline (T1) and were evaluated for frailty 19.9 ± 1.0 years after baseline (T2). CVR was measured at T1 using the breath-holding index and carotid large-vessel disease using ultrasound. Frailty status was measured at T2 according to the physical phenotype developed by Fried. Patients were categorized into CVR tertiles with cutoff points at ≤0.57, 0.58–0.94, and ≥0.95 and also as normal or impaired (<0.69) CVR. We assessed the change in the odds of being in the advanced rank of frailty status (normal, prefrail, and frail) using ordered logistic regression. Results: After adjustment, the estimated OR (95% confidence intervals) for increasing frailty in the lower tertile was 1.94 (1.09–3.46) and in the middle tertile 1.24 (0.70–2.19), compared with the higher CVR tertile. The estimated OR for increasing frailty for patients with impaired vs. normal CVR was 1.76 (1.11–2.80). Conclusions: These findings provide support that cerebral microvascular dysfunction among patients with pre-existing cardiovascular disease is related to prefrailty and frailty and suggest an added value of assessing the cerebral vascular functional status for identifying patients at-risk of developing frailty.

Original languageEnglish
Pages (from-to)1714-1721
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number12
StatePublished - 10 Nov 2018

Bibliographical note

Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.


  • Cardiovascular disease
  • Cerebral hemodynamics
  • Cerebrovascular reactivity
  • Frailty
  • Small vessel disease

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


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