Research Article| Volume 283, ISSUE 1-2, P13-16, August 15, 2009

Can beta stiffness index be proposed as risk factor for dementia

Published:March 16, 2009DOI:


      Background and aim

      Changes of arterial stiffness indicate alteration in arterial mechanics predisposing to the evolution of stroke or vascular dementia. The aim of this pilot study was to investigate whether ultrasound parameters, particularly beta stiffness index (BSI), should be further explored as independent markers or risk factors for dementia.

      Patients and methods

      There were 38 demented patients included in this study (72.53±7.87 yrs) and 33 clinically healthy controls (68.85±3.52 yrs). Risk factors were noted and ultrasound measurements performed on common carotid artery (CCA) using eTracking software on Aloka ProSound ALPHA 10 with 13 MHz linear probe. Level of significance was p<0.05.


      Arterial hypertension was present in 24 patients, atrial fibrillation in 9, diabetes in 3, and hypercholesterolemia in 18. Hypertension was present as a single risk factor in 15 controls with average diastolic blood pressure significantly lower in patients. Significantly higher in patients were mean intima-media thickness, systolic and diastolic CCA diameters (CD), and mean BSI in CCA bilaterally. Linear regression analysis for groups of Alzheimer's dementia and vascular dementia proved that MMSE of the two groups relates to CCA diameter change (CDc) and BSI change explaining up to 5% of variability.


      CD, CDc and BSI should be monitored in patients with cognitive decline and further explored as possible independent markers or risk factors; in future studies groups of demented and non-demented patients should be age, sex and risk factor matched.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Neurological Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Rothwell P.M.
        Lancet. 2001; 357: 1612-1616
        • Wolfson C.
        • Wolfson D.B.
        • Asgharian M.
        • M'Lan C.E.
        • Ostbye T.
        • Rockwood K.
        • et al.
        Clinical Progression of Dementia Study Group. A reevaluation of the duration of survival after the onset of dementia.
        N Engl J Med. 2001; 344: 1111-1116
        • Hatchinski V.
        Stroke and vascular cognitive impairment: a transdisciplinary, translational and transactional approach.
        Stroke. 2007; 38: 1396-1403
        • Hachinski V.
        • Iadecola C.
        • Petersen C.
        • Breteler M.M.
        • Nyenhuis D.L.
        • Black S.E.
        • et al.
        National Institute of Neurological Disorders and Stroke–Canadian stroke network vascular cognitive impairment harmonization standards.
        Stroke. 2006; 37: 2220-2241
        • Demarin V.
        • Lovrencic-Huzjan A.
        • Seric V.
        • Vargek-Solter V.
        • Trkanjec Z.
        • Vukovic V.
        • et al.
        Recommendations for stroke management.
        Acta Clin Croat. 2002; 40: 127-155
        • Bouchard R.W.
        Diagnostic criteria of dementia.
        Can J Neurol Sci. 2007; 34: S11-18
        • Lafleche A.B.
        • Pannier B.H.
        • Laloux B.
        • Safar M.E.
        Arterial response during cold pressor test in borderline hypertension.
        Am J Physiol. 1998; 275: H409-415
        • Azad N.A.
        • Al Bugami M.
        • Loy-English I.
        Gender differences in dementia risk factors.
        Gend Med. Jun 2007; 4: 120-129
        • Yamamoto H Watanabe T.
        • Miyazaki A.
        • Katagiri T.
        • Idei T.
        • Iguchi T.
        • Mimura M.
        • et al.
        High prevalence of Chlamydia pneumoniae antibodies and increased high-sensitive C-reactive protein in patients with vascular dementia.
        J Am Geriatr Soc. 2005; 53: 583-589
        • Watanabe T Miyazaki A.
        • Katagiri T.
        • Yamamoto H.
        • Idei T.
        • Iguchi T.
        Relationship between serum insulin-like growth factor-1 levels and Alzheimer's disease and vascular dementia.
        J Am Geriatr Soc. 2005; 53: 1748-1753
        • Ries F.
        • Horn R.
        • Hillekamp J.
        • Honisch C.
        • König M.
        • Solymosi L.
        Differentiation of multi-infarct and Alzheimer dementia by intracranial hemodynamic parameters.
        Stroke. 1993; 24: 228-235
        • Demchuk A.M.
        • Burgin W.S.
        • Christou I.
        • Felberg R.A.
        • Barber P.A.
        • Hill D.
        • et al.
        Thrombolysis in brain ischemia (TIBI) transcranial Doppler flow grades predict clinical severity, early recovery, and mortality in patients treated with intravenous tissue plasminogen activator.
        Stroke. 2001; 32: 89-93
        • Mathiesen E.B.
        • Waterloo K.
        • Joakimsen O.
        • Bakke S.J.
        • Jacobsen E.A.
        • Bønaa K.H.
        Reduced neuropsychological test performance in asymptomatic carotid stenosis: the Tromsø study.
        Neurology. 2004; 62: 695-701
        • Matteis M.
        • Silvestrini M.
        • Troisi E.
        • Bragoni M.
        • Vernieri F.
        • Caltagirone C.
        Cerebral hemodynamic patterns during stimuli tasks in multi-infarct and Alzheimer types of dementia.
        Acta Neurol Scand. 1998; 97: 374-380
        • Liebetrau M.
        • Herzog J.
        • Kloss C.U.
        • Hamann G.F.
        • Dichgans M.
        Prolonged cerebral transit time in CADASIL: a transcranial ultrasound study.
        Stroke. 2002; 33: 509-512
        • Niki K.
        • Sugawara M.
        • Chang D.
        • Harada A.
        • Okada T.
        • Sakai R.
        • et al.
        A noninvasive measurement system for wave intensity: evaluation of carotid arterial wave intensity and reproducibility.
        Heart Vessels. 2002; 17: 12-21
        • Lakatta E.G.
        • Levy D.
        Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises. Part I: Aging arteries: “set up” for vascular disease.
        Circulation. 2003; 107: 139-146
        • Aviv A.
        • Levy D.
        • Mangel M.
        Growth, telomere dynamics and successful and unsuccessful human aging.
        Mech Ageing Dev. 2003; 124: 829-837
        • Henry R.M.
        • Kostense P.J.
        • Dekker J.M.
        • Nijpels G.
        • Heine R.J.
        • Kamp O.
        • et al.
        Carotid arterial remodelling—a maladaptive phenomenon in type 2 diabetes mellitus but not in impaired glucose metabolism: the Hoorn study.
        Stroke. 2004; 35: 671-676
        • Mahmud A.
        • Feely J.
        Effect of smoking on arterial stiffness and pulse pressure amplification.
        Hypertension. 2003; 41: 183-187
        • De Michele M.
        • Panico S.
        • Iannuzzi A.
        • Celentano E.
        • Ciardullo A.V.
        • Galasso R.
        • et al.
        Association of obesity and central fat distribution with carotid artery wall thickening in middle aged women.
        Stroke. 2002; 33: 2923-2928
        • Glavic J.
        • Cerimagic D.
        • Lovrencic-Huzjan A.
        • Vukovic V.
        • Demarin V.
        Frank's sign as a risk factor for cerebrovascular disease.
        Acta Clin Croat. 2007; 46: 11-14
        • O'Rourke M.F.
        • Staessen J.A.
        • Vlachopulos C.
        • Duprez D.
        • Plante G.E.
        Clinical applications of arterial stiffness; definitions and reference values.
        AJH. 2002; 15: 426-444
        • Zavoreo I.
        • Aleksic-Shihabi A.
        • Demarin V.
        Correlation of neurological symptoms and BHI in patients with severe internal carotid stenosis.
        Acta Clin Croat. 2006; 45: 315-318
        • Vukovic V.
        • Molina C.A.
        • Ribo M.
        • Lovrencic-Huzjan A.
        • Budisic M.
        • Demarin V.
        Neuroimaging techniques—improving diagnostic and therapeutic options in acute stroke.
        Acta Clin Croat. 2006; 45: 331-341
        • Ries F.
        • Horn R.
        • Hillekamp J.
        • Honisch C.
        • König M.
        • Solymosi L.
        Differentiation of multi-infarct and Alzheimer dementia by intracranial hemodynamic parameters.
        Stroke. 1993 Feb; 24: 228-235
        • Stewart W.F.
        • Kawas C.
        • Corrada M.
        • Metter E.J.
        Risk of Alzheimer's disease and duration of NSAID use.
        Neurology. 1997; 48: 626-632
        • Jurasic M.J.
        • Lovrencic-Huzajn A.
        • Roje Bedekovic M.
        • Demarin V.
        How to monitor vascular aging with ultrasound.
        J Neurol Sci. 2007; 257: 139-142