Estimated Pulse Wave Velocity Inversely Associates with Cognition in the Northern Manhattan Study (S8.002)

Objective: Determine whether estimated pulse wave velocity (ePWV) is associated with cognition in a racially and ethnically diverse sample of older adults.

Background: Arterial stiffness has been associated with cognitive performance. The gold standard for measuring vascular stiffness is pulse wave velocity using arterial tonometry. Recently, ePWV calculated from age and blood pressure has been associated with cerebrovascular disease.

Design/Methods: We included 1290 stroke-free participants (60% women, mean age 64±8 years, 66% Hispanic, 17% Black, 15% White, mean education 10 years) from the population-based Northern Manhattan Study and calculated ePWV using a non-linear function of age and mean arterial pressure measured at initial visit (ePWV=9.587-(0.402*Age)+(4.560*0.001*Age²)-(2.621*0.00001*Age²*MAP) + (3.176*0.001*Age*MAP)-(1.832*0.01*MAP) where MAP=DBP+0.4*(SBP-DSP). The neuropsychological testing was performed to estimate global cognitive performance and domain-specific episodic memory, executive function, semantic memory, and processing speed. Cognition scores were regressed on ePWV in multivariable linear regression models: Model 1 included age, sex, race/ethnicity, education, time from baseline to cognitive testing; Model 2 added hypercholesterolemia, antihypertensive medication, diabetes, smoking and alcohol use; and Model 3 additionally included white matter hyperintensity volume, silent brain infarcts, and perivascular spaces. Effect modification of ApoE4 was tested by including an interaction term in Model 2.

Results: Mean ePWV for the total sample was 11±2 and did not differ among sex or race-ethnic groups. ePWV was inversely associated with global cognition (b=−0.035, p<0.05), semantic memory (b=−0.049, p<0.05) and processing speed (b=−0.056, p<0.05) after adjustment for demographics and vascular risk factors. In stratified model, greater ePWV was associated with worse processing speed (b=−0.143, p<0.01) in ApoE4 carriers, but not in ApoE4 non-carriers (b=−0.037, p<0.2).

Conclusions: Results suggest an important role of arterial stiffening in age-related cognitive function. APOE 4 carriers with age-related systemic vascular stiffening has much worse cognitive performance as compared to that in non-APOE 4 carriers with age-related systemic vascular stiffening.

Disclosure: Ms. Aimagambetova has nothing to disclose. Ms. Ariko has nothing to disclose. Ms. Gardener has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Intersocietal Accreditation Commission. Ms. Gardener has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ellipse Analytics. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Baum Hedlund. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant with A Green Slate Consulting. Bonnie Levin has nothing to disclose. Dr. Sun has nothing to disclose. Carolina Gutierrez has nothing to disclose. Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy. The institution of Dr. Elkind has received research support from BMS-Pfizer Alliance for Eliquis. The institution of Dr. Elkind has received research support from Roche. Dr. Elkind has received publishing royalties from a publication relating to health care. Dr. Elkind has a non-compensated relationship as a Officer with American Heart Association that is relevant to AAN interests or activities. Dr. Gutierrez has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Roetzel & Andress, JOHN ASTUNO, JR. L.L.C.. The institution of Dr. Gutierrez has received research support from NIH. Dr. Gutierrez has received publishing royalties from a publication relating to health care. Dr. Gutierrez has received publishing royalties from a publication relating to health care. Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy. The institution of Dr. Elkind has received research support from BMS-Pfizer Alliance for Eliquis. The institution of Dr. Elkind has received research support from Roche. Dr. Elkind has received publishing royalties from a publication relating to health care. Dr. Elkind has a non-compensated relationship as a Officer with American Heart Association that is relevant to AAN interests or activities. An immediate family member of Dr. Wright has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. An immediate family member of Dr. Wright has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MARSHALL DENNEHY. The institution of an immediate family member of Dr. Wright has received research support from Oncospace. Dr. Wright has received publishing royalties from a publication relating to health care. An immediate family member of Dr. Wright has received personal compensation in the range of $500-$4,999 for serving as a surveyor with ASTRO. Dr. Sacco has received personal compensation in the range of $100,000-$499,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Sacco has received research support from NIH, NINDS, NCATS, NIMHD. The institution of Dr. Sacco has received research support from FL Department of Health. Dr. Sacco has received research support from University of Washington, Seattle. Dr. Sacco has received publishing royalties from a publication relating to health care. Ms. Cabral has nothing to disclose. The institution of Dr. Rundek has received research support from NIH.