Estimated pulse wave velocity and cognitive decline over time in ageing adults

Abstract

Aim: Estimated pulse wave velocity (ePWV) is a validated measure of arterial stiffness. While linked to cardiovascular disease, its longitudinal relationship with domain-specific cognitive decline in the general ageing population remains to be fully established.

Methods: We studied 5,080 participants (median age 64.0 years) from the English Longitudinal Study of Ageing (waves 2-9, 2004-2019). Baseline ePWV was calculated from age and mean blood pressure. Cognitive function (global, memory, executive, orientation) was assessed biennially. We used multivariable-adjusted linear mixed models to examine associations between baseline ePWV (natural log-transformed) and the rate of cognitive decline across a median follow-up duration of 10.1 years.

Results: In cross-sectional analysis, higher baseline ePWV was linked to poorer cognitive scores across all domains (all P < 0.001). Longitudinally, each unit increase in log-ePWV was linked to an accelerated annual decline in global cognitive score (-0.024 points/year; 95% confidence interval (CI) -0.026 to -0.021), memory (-0.022; -0.024 to 0.019), executive function (-0.019; -0.022 to -0.016), and orientation (-0.017; -0.021 to -0.013). A distinct dose-response pattern was evident: compared to the lowest quartile, participants in the highest ePWV quartile experienced the fastest decline in global cognition (-0.128 points/year), memory (-0.118/year), and executive function (-0.102/year) (P for trend < 0.001).

Conclusion: Higher arterial stiffness, as measured by ePWV, is independently linked to accelerated long-term decline across diverse cognitive domains in community-dwelling older adults. ePWV may be a useful vascular biomarker linked to increased cognitive decline risk, requiring confirmation in prospective studies.

Keywords

Estimated pulse wave velocity / cognitive decline / trajectory / ELSA

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