Longitudinal trajectories of pulse wave velocity and cognition in the Irish longitudinal study of ageing (TILDA)

Abstract

Introduction: Arterial stiffness is a marker of vascular ageing and carotid–femoral pulse wave velocity (cf-PWV) is a standard measurement method. A raised cf-PWV in individuals has been associated cross-sectionally with poor cognition and longitudinally with increased incidence of hypertension, cardiovascular events, and mortality. We hypothesized that individuals who have accelerated vascular ageing will also have greater cognitive decline and explored that potential association in Wave 1 (W1) and Wave 3 (W3) of The Irish Longitudinal Study on Ageing (TILDA). Methods: cf-PWV was measured by tonometry (Vicorder®) and the average of two PWV measurements between the carotid and femoral arteries was used. Global cognition was assessed at the health center, using the Mini Mental State Exam (MMSE) and Montreal Cognitive Assessment (MOCA), which were repeated at W1 (4-year follow-up period). Linear regression analyzes were employed to predict change in cognitive measure by PWV change quintiles, whilst controlling by age, sex, education, smoking, body mass index, cardiovascular diseases and depression. Results: 3274 participants had data at both W1 and W3 for analysis (mean age 64, mean cf-PWV at W1 =10.4 m/s). In the fully adjusted model, the highest quintile of cf-PWV change was significantly associated with greater decreases in MMSE (0.303, 95% CI: 0.054–0.397, p =0.011) and MOCA (0.416, 95% CI: 0.185–0.726, p =0.027) between W1 and W3. Conclusions: Over a 4-year period, participants in the highest quintile of cf-PWV increase demonstrated greater decreases in both MOCA and MMSE when compared to those in the lowest quintile. Treating causes of accelerated cf-PWV progression may have a role in preserving global cognition.