Cerebral hemodynamics in the elderly a transcranial doppler study in the Einstein aging study cohort

Dixon Yang, Digna Cabral, Emmanuel N. Gaspard, Richard B. Lipton, Tatjana Rundek, Carol A. Derby

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Objectives-We sought to describe the relationship between age, sex, and race/ethnicity with transcranial Doppler hemodynamic characteristics from major intracerebral arterial segments in a large elderly population with varying demographics. Methods-We analyzed 369 stroke-free participants aged 70 years and older from the Einstein Aging Study. Single-gate, nonimaging transcranial Doppler sonography, a noninvasive sonographic technique that assesses real-time cerebrovascular hemodynamics, was used to interrogate 9 cerebral arterial segments. Individual Doppler spectra and cerebral blood flow velocities were acquired, and the pulsatility index and resistive index were calculated by the device's automated waveform-tracking function. Multiple linear regression models were used to examine the independent associations of age, sex, and race/ethnicity with transcranial Doppler measures, adjusting for hypertension, history of myocardial infarction or revascularization, and history of diabetes. Results-Among enrolled participants, 303 individuals had at least 1 vessel insonated (mean age [SD], 80 [6] years; 63% women; 58% white; and 32% black). With age, transcranial Doppler measures of mean blood flow velocity were significantly decreased in the basilar artery (P = .001) and posterior cerebral artery (right, P = .003; left, P = .02). Pulsatility indices increased in the left middle cerebral artery (P = .01) and left anterior cerebral artery (P = .03), and the resistive index was increased in the left middle cerebral artery (P= .007) with age. Women had higher pulsatility and resistive indices compared to men in several vessels. Conclusions-We report a decreased mean blood flow velocity and weakly increased arterial pulsatility and resistance with aging in a large elderly stroke-free population. These referential trends in cerebrovascular hemodynamics may carry important implications in vascular diseases associated with advanced age, increased risk of cerebrovascular disease, cognitive decline, and dementia.

Original languageEnglish (US)
Pages (from-to)1907-1914
Number of pages8
JournalJournal of Ultrasound in Medicine
Issue number9
StatePublished - Sep 1 2016


  • Aging
  • Blood flow velocities
  • Cerebral hemodynamics
  • Head and neck ultrasound
  • Pulsatiliy index
  • Resistive index
  • Transcranial Doppler sonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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