{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:18:51Z","timestamp":1792034331628,"version":"4.4.0"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Patients with cardiovascular disease are at increased risk for cognitive decline. We studied the occurrence and profile of cognitive impairment in 3 patient groups as exemplar conditions of hemodynamic disturbances at different levels of the heart-brain axis, including patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (possible vascular cognitive impairment [VCI]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>\n              In 555 participants (160 HF, 107 COD, 160 possible VCI, 128 reference participants; 68\u00b19 years; 36% F; Mini-Mental State Examination 28\u00b12), we assessed cognitive functioning with a comprehensive test battery. Test scores were transformed into\n              <jats:italic>z<\/jats:italic>\n              -scores. Compound\n              <jats:italic>z<\/jats:italic>\n              -scores were constructed for: memory, language, attention\/psychomotor speed, executive functioning, and global cognitive functioning. We rated cognitive domains as impaired when\n              <jats:italic>z<\/jats:italic>\n              -score\u2264\u22121.5. Based on the number of impaired domains, patients were classified as cognitively normal, minor, or major cognitive impairment. We used general linear models and \u03c7\n              <jats:sup>2<\/jats:sup>\n              tests to compare cognitive functioning between patient groups and the reference group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Age, sex, and education adjusted global cognitive functioning z-score was lower in patients with COD (\u03b2 [SE]=\u22120.46 [0.10],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and possible VCI (\u03b2 [SE]=\u22120.80 [0.09],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) compared with reference participants. On all domains,\n              <jats:italic>z<\/jats:italic>\n              -scores were lower in patients with COD and possible VCI compared with reference participants. Patients with HF had lower z-scores on attention\/speed and language compared with reference participants. Cognitive impairment was observed in 18% of HF, 36% of COD, and 45% possible VCI. There was no difference in profile of impaired cognitive domains between patient groups. Memory and attention-psychomotor speed were most commonly affected, followed by executive functioning and language.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>A substantial part of patients with HF and COD had cognitive impairment, which warrants vigilance for the occurrence of cognitive impairment. These results underline the importance of an integrative approach in medicine in patients presenting with disorders in the heart-brain axis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.119.026031","type":"journal-article","created":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T10:02:16Z","timestamp":1572948136000},"page":"3369-3375","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Frequent Cognitive Impairment in Patients With Disorders Along the Heart-Brain Axis"],"prefix":"10.1161","volume":"50","author":[{"given":"Astrid M.","family":"Hooghiemstra","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (A.M.H., A.E.L., W.M.v.d.F.), Amsterdam UMC, location VUmc, the Netherlands"},{"name":"Department of Medical Humanities, Amsterdam Public Health Research Institute (A.M.H.), Amsterdam UMC, location VUmc, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Leeuwis","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (A.M.H., A.E.L., W.M.v.d.F.), Amsterdam UMC, location VUmc, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Suzannne","family":"Bertens","sequence":"additional","affiliation":[{"name":"Department of Radiology (A.S.B.)"},{"name":"Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands (A.S.B.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert Jan","family":"Biessels","sequence":"additional","affiliation":[{"name":"Department of Neurology, UMC Utrecht Brain Center (G.J.B., L.J.K.), University Medical Center Utrecht, Utrecht University, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel L.","family":"Bots","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care (M.L.B., J.P.G.), University Medical Center Utrecht, Utrecht University, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Brunner-La Rocca","sequence":"additional","affiliation":[{"name":"Department of Cardiology (H.-P.B.-L.R.), Maastricht University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacoba P.","family":"Greving","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care (M.L.B., J.P.G.), University Medical Center Utrecht, Utrecht University, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Jaap","family":"Kappelle","sequence":"additional","affiliation":[{"name":"Department of Neurology, UMC Utrecht Brain Center (G.J.B., L.J.K.), University Medical Center Utrecht, Utrecht University, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"van Oostenbrugge","sequence":"additional","affiliation":[{"name":"Department of Neurology (R.J.v.O.), Maastricht University Medical Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert C.","family":"van Rossum","sequence":"additional","affiliation":[{"name":"Department of Cardiology (A.C.v.R.), Amsterdam UMC, location VUmc, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Heart-Brain Connection Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiesje M.","family":"van der Flier","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (A.M.H., A.E.L., W.M.v.d.F.), Amsterdam UMC, location VUmc, the Netherlands"},{"name":"Department of Epidemiology (W.M.v.d.F.) Amsterdam UMC, location VUmc, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","unstructured":"World Health Organization. Cardiovascular diseases (CVDs): http:\/\/www.who.int\/mediacentre\/factsheets\/fs317\/en\/; 2017. Accessed April 23 2018."},{"key":"e_1_3_4_3_2","first-page":"1","article-title":"World alzheimer report 2018. The state of the art of dementia research: new frontiers.","author":"Patterson C","year":"2018","unstructured":"Patterson, C. World alzheimer report 2018. The state of the art of dementia research: new frontiers. Alzheimer\u2019s Dis Int. 2018;1\u201348.","journal-title":"Alzheimer\u2019s Dis Int"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e3182299496"},{"key":"e_1_3_4_5_2","unstructured":"Bots ML Buddeke J van Dis I Vaartjes I Visseren FLJ; on behalf of Hartstichting. Hart- en vaatziekten in Nederland 2017. https:\/\/www.hartstichting.nl\/getmedia\/cd75c3f5-9cd2-4558-b53c-87295bf0e6b7\/cijferboek-hartstichting-hart-vaatziekten-nederland-2017.pdf; 2017. Accessed February 27 2018."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.905091"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000366469"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr253"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2006.01.005"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.108.126342"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.093674"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(03)00305-3"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2014.01.001"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.009475"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2015.12.015"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000480738"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.JCN.0000305096.09710.ec"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01395.x"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft020"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.535245"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.04.038"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000113759.80877.1f"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-4-200402170-00005"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-003-0222-1"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2018.09.006"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_3_4_27_2","volume-title":"Intelligentie En Leeftijd: Onderzoek Bij Nederlanders Van 12-77 Jaar [in Dutch]","author":"Verhage F","year":"1964","unstructured":"Verhage, F. Intelligentie En Leeftijd: Onderzoek Bij Nederlanders Van 12-77 Jaar [in Dutch]. Assen: Van Gorcum; 1964."},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-014-0254-4"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.43.11.2412-a"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617705050344"},{"key":"e_1_3_4_32_2","volume-title":"L\u2019examen Clinique En Psychologie","author":"Rey A","year":"1964","unstructured":"Rey, A. L\u2019examen Clinique En Psychologie. Paris: Presse de Universitaire de France; 1964."},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.73.2.126"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617706060115"},{"key":"e_1_3_4_35_2","volume-title":"Handleiding Groninger Intelligentie Test (Manual Groningen Intelligence Test)","author":"Luteijn P","year":"1983","unstructured":"Luteijn, P, Van der Ploeg, F. Handleiding Groninger Intelligentie Test (Manual Groningen Intelligence Test). Lisse: Swets & Zeitlinger; 1983."},{"key":"e_1_3_4_36_2","volume-title":"WAIS-III: Wechsler Adult Intelligence Scale (3rd ed.) Administration and Scoring Manual","author":"Wechsler D","year":"1997","unstructured":"Wechsler, D. WAIS-III: Wechsler Adult Intelligence Scale (3rd ed.) Administration and Scoring Manual. San Antionio, TX: Psychological Corporation\/Harcourt Brace; 1997."},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/13803390591004428"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1037\/h0044509"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/1073191105283427"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1037\/h0054651"},{"key":"e_1_3_4_41_2","volume-title":"De Stroop-Kleur Woord Test: Handleiding [The Stroop Color-Word Test: Manual]","author":"Hammes J","year":"1973","unstructured":"Hammes, J. De Stroop-Kleur Woord Test: Handleiding [The Stroop Color-Word Test: Manual]. Amsterdam: Swets & Zeitlinger; 1973."},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e31819431d5"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2017.09.020"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trci.2017.02.002"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-019-1089-9"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493018790088"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.3"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2014.01.003"},{"key":"e_1_3_4_49_2","first-page":"1","article-title":"Measuring longitudinal cognition: individual tests versus composites.","author":"Jonaitis EM","year":"2018","unstructured":"Jonaitis, EM, Koscik, RL, Clark, LR, Ma, Y, Betthauser, TJ, Berman, SE, et al. Measuring longitudinal cognition: individual tests versus composites. Alzheimer\u2019s Dement Diagnosis Assess Dis Monit. 2018;1\u201311.","journal-title":"Alzheimer\u2019s Dement Diagnosis Assess Dis Monit"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0000000000000034"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.2196\/resprot.6864"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-170850"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.119.026031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T15:27:47Z","timestamp":1715614067000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.119.026031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":52,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1161\/STROKEAHA.119.026031"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.119.026031","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]},"assertion":[{"value":"2019-04-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}