Abstract 2392: Arterial Stiffness as an Independent Predictor of Longitudinal Changes in Cognitive Function in the Elderly
Cognitive decline is one of the major factors contributing to disability in the elderly. We have previously demonstrated cross-sectionally that arterial stiffness, measured non-invasively as Pulse Wave Velocity (PWV), was associated with memory loss independently of traditional CV risk factors and independent of neuroimaging findings in elderly subjects without prior stroke. The aim of the present study was to evaluate PWV as a predictor of longitudinal changes in cognitive function in elderly reporting memory problems.
Subjects and Methods: We studied 102 elderly (mean age 79±6 yrs, range 64 –90; 31 M, 71 F) reporting memory problems. PWV was measured non-invasively by Complior®. Traditional CV risk factors levels were measured. Global cognitive function was measured by Mini-Mental State Examination (MMSE) (maximum score=30). A cerebral CT scan was performed to evaluate the presence of microvascular damage or cortical atrophy. Subjects with prior stroke or atrial fibrillation were excluded. After a median follow-up of 12 months (maximum 32 months) MMSE was measured again. Multiple regression analysis was performed, including age, sex, education, traditional CV risk factors, creatinine, basal MMSE, and PWV as covariates.
Results: Baseline MMSE was 22.9 ± 5.5; 61% were hypertensive, 26.8% diabetic, 9.4% smoking, 10.5% taking statins, 21.1% nitrates. Average PWV was 13.5 ± 2.2 m/sec. After a median follow-up of 12 months, 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 (for each 1 m/sec of PWV increase an average 0.74 per year decrease of MMSE points was expected , p< 0.001).
Conclusion: In elderly subjects, arterial stiffness (PWV) is a strong predictor of loss in cognitive function, independently of age, sex, education, and traditional CV risk factors. Future studies will confirm whether targetting subjects with increased arterial stiffness would be an effective strategy to prevent dementia.