Arterial Stiffness in Older Adults Predicts Future Dementia

Megan Brooks

July 31, 2018

CHICAGO  — Arterial stiffness is associated with an increased risk for dementia onset in older elderly persons, new research shows.

Results from the longitudinal Pittsburgh Cardiovascular Health Study-Cognition (CHS-CS) show that among adults in their 70s at baseline, higher large-artery stiffness, measured by carotid-femoral pulse wave velocity (cfPWV), independently predicted higher dementia risk over 15 years.

"It is of interest whether interventions targeting arterial stiffness will be effective in reducing the risk of dementia," said lead investigator Chendi Cui, from the University of Pittsburgh, Pennsylvania.

The findings were presented here at the Alzheimer's Association International Conference (AAIC) 2018.

Dementia Predictor

Arterial stiffness occurs with aging and is associated with cognitive decline, cerebral small-vessel arteriosclerotic disease, and brain amyloid deposition and therefore may predict incident dementia, said Cui.

To investigate, she and her colleagues studied 356 CHS-CS participants (59% women) without dementia at baseline (1998 - 1999) who had annual cognitive exams through 2013 and cfPWV measured between 1996 and 2000. Participants had a mean age of 78 years at baseline.

Of the 356 participants, 212 (59.6%) developed dementia over 15 years. The median time to dementia onset was 4 years.

After adjustment for age, sex, education, race, APOE ε4 genotype status, diabetes, and hypertension, higher cfPWV (highest vs lowest quartile) was associated with a 60% higher risk for incident dementia (hazard ratio [HR] 1.60; 95% confidence interval, 1.05 - 2.51), Cui reported.

Further adjustment for the Modified Mini-Mental Status Examination score, white matter grade, ventricular grade, or large infarcts did not significantly attenuate the association.

Dementia risk was not modified by baseline mild cognitive impairment (MCI), as indicated by similar HRs for those with baseline normal cognition and MCI and the absence of a statistical interaction.

Lower physical activity intensity and higher systolic blood pressure, heart rate, and waist circumference measured about 5 years before cfPWV measurement were significantly associated with greater arterial stiffness.  This suggests that preventive interventions directed at these risk factors may lower dementia risk by reducing arterial stiffness, Cui said.

Heart Health Strongly Tied to Brain Health

These findings "fit in with the whole concept of heart health being tied to brain health  makes sense," Keith Fargo, PhD, director of scientific programs and outreach for the Alzheimer's Association, told Medscape Medical News.

"The brain is hungry for oxygen and nutrients, which involve the cardiovascular system and having healthy blood vessels to bring oxygen and nutrients to brain cells that need them so much. If anything is happening to compromise the cardiovascular system, it seems fairly obvious that it's going to compromise the brain and it's nice to actually see data to support that," said Fargo.

The study had no commercial funding. Cui and Fargo have disclosed no relevant financial relationships.

Alzheimer's Association International Conference (AAIC) 2018. Abstract 25170. Presented July 24, 2018.

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