Arterial Stiffness in Older Adults Predicts Future Dementia

The longitudinal Pittsburgh Cardiovascular Health Study-Cognition (CHS-CS) presented at the Alzheimer's Association International Conference 2018 demonstrated that among adults in their 70s at baseline, higher large-artery stiffness—measured by carotid-femoral pulse wave velocity (cfPWV)—independently anticipated higher dementia risk over 15 years, according to MedScape . The researchers examined 356 CHS-CS participants, mean age 78, without dementia at baseline who had annual cognitive exams through 2013 and cfPWV quantified between 1996 and 2000. A total of 212 developed dementia over 15 years, with four years the median time to onset. After adjusting for age, sex, education, race, APOE E4 genotype status, diabetes, and hypertension, higher cfPWV was linked to a 60 percent greater risk for incident dementia. Furthermore, white matter grade, ventricular grade, or large infarcts did not significantly strengthen this association, nor was dementia risk modified by baseline mild cognitive impairment (MCI), as indicated by similar hazard ratios for those with baseline normal cognition and MCI and the lack of a statistical interaction. Reduced physical activity intensity and higher systolic blood pressure, heart rate, and waist circumference measured about five years before cfPWV measurement were significantly connected to greater arterial stiffness. The implication is that preventive interventions targeting these risk factors may lower dementia risk by reducing arterial stiffness.