v. Ehrlich B, Internist, Kempten/Allgäu

Background: Several epidemiological studies have detected a correlation between Magnesium-depletion and
dementia on the one hand (Barbagallo 2011; Lemke 1995) – dementia and increased vascular stiffness on the
other hand. Lately the positive influence of 24wks oral Mg supplementation in RCT setting has been
demonstrated (Joris 2016). AIX (Augmentation Index of pulse wave) a non-invasive parameter of microvascular
stiffness is a biomarker of cardiovascular mortality-risk. The present retrospective analysis identified dementia
patients with known long time development, documented pathological AIX values and their long years
evaluated Magnesium-level.

Methods/Materials: 224 subsequent patients with CV-riskindicators between oct 2015 - march 2016 in our
internal medicine ambulance were submitted to pulse-wave-analysis with the parameters PWV for
macrovascular and AIX for microvascular stiffness (Mobilograph® device IEM Aachen Ger). Patients above 60 y
where tested with “clocktest” as screening of cerebral fitness. On basis of clocktest and clinical signs a
subgroup of 14 patients with dementia was identified. Of all patients of the dementia-group serum Magnesium
levels and Mg/Ca-Quotient where retrospectively compiled as far as previously analyzed.

Results: All 14 patients of the dementia cohort (Ø 82,2y -69-91y-12f/2m) had a long term (4-11y) documented
Magnesium depletion of different intensity. The initial Mgs was Ø 0,799 mmol/l. During long term
recommended Mg-supplementation – with different compliance due to non refundable prescription in German
social incurancy system – Mgs over Ø 9.2 years was analyzed with Ø 0,8275 mmol/l – based on 209 analyzes (Ø
14.9 analyses /patient). The age related AIX + 2SD was above normal in 6/14 patients , AIX over 35% in 10/14,
AIX over age mean in 12/14. The two patients with normal resp. good AIX are 1 pt with Levy body dementia
(hallucinations) and one with persistent high Mgs – so both exceptional cases. The Mg/Ca-Q in 6/14pt was in
the mean <0,35. The cumulative Mobilograph-Algorythm detected 12/14 pt as “older” vasc.stiffness than an
age equivalent normal cohort. From ongoing investigations with parenteral (i.v) Mg therapy we can conclude
the assumption that AIX and therewith the microvascular function reacts the most sensitive on magnesium
therapy. Synoptic analysis of all three parameters (Mgs-Mg/Ca-Q-Vasc.age) leads to best sensitivity.

Conclusions: Dementia patients often have preceeding microvascular aging detectable noninvasively within 15
min and often coincident with suboptimal Magnesium levels
Hypothesis: The method of measuring vascular stiffness in combination with analysis of Mgs and Mg/Ca-Q
might be a helpful and cheap instrument of early diagnosis of treatable EVA (early vascular aging) and by long
term optimizing of Mg/Ca-Q possibly microvascular degenerative and dementia processes as part of a
multicausal development (Rothemans rule) can be retarded.