Arterial stiffness as an independent predictor of longitudinal changes in cognitive function in the older individual.
BACKGROUND
Cognitive decline significantly contributes to disability in older individuals. We previously demonstrated cross-sectionally that arterial stiffness [pulse wave velocity (PWV)] was associated with memory loss independently of traditional cardiovascular risk factors and of neuroimaging findings in older individuals without prior stroke. The present study aimed to evaluate PWV as a predictor of longitudinal changes in cognitive function in older individuals reporting memory problems.


METHODS
We studied 102 older individuals (mean age 79 +/- 6 years; 31 men, 71 women) reporting memory problems. PWV was measured noninvasively by Complior. Traditional cardiovascular risk factor levels were measured. Global cognitive function was measured by the Mini-Mental State Examination (MMSE) (maximum score = 30) at baseline and at follow-up visit. Cerebral computed tomography evaluated the presence of microvascular damage or cortical atrophy. Individuals with prior stroke or atrial fibrillation were excluded.


RESULTS
The baseline MMSE was 22.9 +/- 5.5; 61% were hypertensive, 26.8% diabetic, 9.4% smokers, 10.5% taking statins, and 21.1% taking nitrates. The average PWV was 13.5 +/- 2.2 m/s. After a median follow-up of 12 months, the average per-year decline in MMSE was 2.9 points or 12.1%. Multiple regression models showed that PWV independently predicted cognitive decline (model R2 = 0.50). PWV was the single strongest predictor of cognitive decline, explaining 15.2% of the total variance (each 1 m/s increase in PWV was associated with an average 0.74 per-year decrease in MMSE score, P < 0.001).


CONCLUSIONS
In older individuals, arterial stiffness (PWV) is a strong predictor of loss in cognitive function, independent of age, sex, education, and traditional cardiovascular risk factors.
Scuteri
Angelo
A
UO Geriatria, INRCA/IRCCS, Rome, Italy. angeloelefante@interfree.it
Tesauro
Manfredi
M
Appolloni
Sergio
S
Preziosi
Francesca
F
Brancati
Anna Maria
AM
Volpe
Massimo
M
D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D004548:Elasticity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000503:physiopathology*; D011674:Pulse