Peripheral arterial disease and cognitive function

Shari R. Waldstein, Carol F. Tankard, Karl J. Maier, Jessica R. Pelletier, Joseph Snow, Andrew W. Gardner, Richard Macko, Leslie I. Katzel

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Objective: Peripheral arterial disease (PAD) is associated with comorbid atherosclerosis of the coronary and carotid arteries and is a significant risk factor for stroke. However, cognitive function in PAD patients before clinically evident stroke remains poorly characterized. Here we hypothesized that, on neuropsychological testing, PAD patients would perform more poorly than healthy control subjects, and persons with mild cardiovascular disease (essential hypertension), but better than stroke patients, thus reflecting a continuum of cognitive impairment associated with increased severity of vascular disease. Method: The cognitive performance of 38 PAD patients (mean ankle-brachial index=0.67, Fontaine Class II) was contrasted with that of 23 healthy normotensive controls, 20 essential hypertensives, and 26 anterior ischemic stroke patients on twelve neuropsychological tests. Results: PAD patients performed significantly more poorly than hypertensives and normotensives, but better than stroke patients, on seven tests of nonverbal memory, concentration, executive function, perceptuo-motor speed, and manual dexterity. Hypertensives displayed poorer performance than normotensives on tests of nonverbal memory and manual dexterity. These findings were independent of age, education, and depression scores. Higher diastolic blood pressure and plasma glucose levels predicted poorer performance of select cognitive tests by PAD patients. Eight to 67% of PAD patients displayed impaired performance (< 5th percentile of normotensive controls) on the seven aforementioned cognitive tests. Conclusions: PAD patients exhibit diminished performance across a variety of domains of cognitive function. Findings also suggest a continuum of cognitive impairment associated with increasingly severe manifestations of cardiovascular disease, thus emphasizing the need for enhanced preventative measures to avert functional declines.

Original languageEnglish (US)
Pages (from-to)757-763
Number of pages7
JournalPsychosomatic medicine
Issue number5
StatePublished - Sep 2003

All Science Journal Classification (ASJC) codes

  • Applied Psychology
  • Psychiatry and Mental health


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