Estimated Arterial Stiffness as a Predictor of Cognitive Decline and Dementia in Middle-Aged and Older Adults

Kevin Heffernan
Associate Professor of Exercise Science, Syracuse University
Janet Wilmoth
Professor of Sociology, Syracuse University
Andrew London
Professor of Sociology, Syracuse University

Background: With aging, large arteries outside of the brain lose elasticity. Elevated levels of arterial stiffness expose the brain to high blood pressure that causes structural damage [23]. Numerous cross-sectional studies now support a strong association between arterial stiffening and β-amyloid plaque deposition and atrophy of key areas of the brain implicated in the pathogenesis of cognitive aging and ADRD development [24-27]. Arterial stiffness also prospectively predicts cognitive decline [28-30] and transition to dementia in older adults [31-33]. As such, arterial stiffness may be a useful vascular biomarker to predict age-related cognitive decline and transition from mild cognitive impairment (MCI) to more severe dementia in the general population.

The gold standard method for assessing arterial stiffness, carotid-femoral pulse wave velocity (cfPWV), requires specialized, relatively expensive equipment and considerable technical proficiency, which limits it widespread adoption [34]. cfPWV can be estimated from two commonly measured clinical variables – age and blood pressure- and we have shown this estimated pulse wave velocity (ePVW) is an independent predictor of cardiovascular and cerebrovascular aging to consider the relationship between ePWV, cognitive decline, and dementia.

Aim 1:  Examine ePWV as a predictor of cognitive decline in middle aged and older adults. We hypothesize that higher arterial stiffness will predict a steeper age-related decline in cognitive function.
Aim 2: Examine ePWV as a predictor of the transition from MCI to dementia in middle-aged and older adults. We hypothesize higher arterial stiffness will be associated with a higher risk of transitioning from MCI to having dementia.