Arterial pulse wave velocity as a marker of poor cognitive function in an elderly community-dwelling population.
BACKGROUND
Knowledge about potentially modifiable risk factors for cognitive decline is limited at this time. The aim of this study was to determine the cross-sectional relationship between a low level of cognitive function and brachial-ankle pulse wave velocity (baPWV) in a community-dwelling elderly population.


METHODS
The study population included 352 community-dwelling Japanese persons ages 70 years and older who participated in a comprehensive health examination in April 2003. None had any history of cardiovascular disease. In addition to conventional medical examinations such as blood pressure and routine blood analyses, cognitive function was tested using the Mini-Mental State Examination (MMSE), and baPWV was determined using a recently developed noninvasive and automatic arterial waveform analyzer (AT-Form). This measure, with well-established validity and reproducibility, reflects both central and peripheral arterial flow. A multivariate logistic regression model tested the possible association between poor cognitive function (an MMSE score < 24) and baPWV.


RESULTS
Poor cognitive function was independently associated with the middle tertile of baPWV (odds ratio [OR] = 9.66, 95% confidence interval [CI] = 1.15 to 80.93), age (1-year increment; OR = 1.12, 95% CI = 1.04 to 1.22), and the highest tertile of pulse pressure (OR = 4.70, 95% CI = 1.08 to 20.48) even after multivariate adjustment of data for the effects of age, educational level, and hemodynamic and metabolic antecedents of atherosclerosis.


CONCLUSIONS
A high baPWV may be a potent risk factor for poor cognitive function in an elderly community-dwelling population, and this effect is independent of another marker of arterial stiffness: pulse pressure.
Community Health Research Group, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan. fujiwayo@tmig.or.jp
Yoshinori
Y
Fujiwara
Paulo H M
PH
Chaves
Ryutaro
R
Takahashi
Hidenori
H
Amano
Hiroto
H
Yoshida
Shu
S
Kumagai
Koji
K
Fujita
Dou Gui
DG
Wang
Shoji
S
Shinkai
D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply; D015415:Biomarkers / Q000032:analysis; D001916:Brachial Artery / Q000503:physiopathology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010991:Plethysmography / Q000295:instrumentation; D011336:Probability; D011673:Pulsatile Flow / Q000502:physiology*; D012111:Residence Characteristics; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers