Estimated pulse wave velocity associated with cognitive phenotypes in a rural older population in China: A cohort study

INTRODUCTION

To examine the longitudinal association between estimated pulse wave velocity (ePWV) and cognitive phenotypes in a rural Chinese older population.

METHODS

This population-based study included 1857 dementia-free participants (age ≥60 years) who were examined in 2014 and followed in 2018. ePWV was calculated using age and mean blood pressure (MBP). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and neuropsychological tests. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Data were analyzed using Cox proportional-hazards models, linear regression models, and restricted cubic spline (RCS) curves.

RESULTS

Per 1-m/s increase in ePWV was associated with an adjusted hazard ratio (HR) (95% confidence interval [CI]) of 1.51(1.30–1.75) for dementia and 1.58(1.33–1.89) for Alzheimer's disease (AD), and with an MMSE score decline (adjusted β-coefficient = −0.36; 95% CI = −0.52 to −0.21). A nonlinear association was observed between baseline ePWV and follow-up cognitive scores.

DISCUSSION

A higher ePWV is associated with an increased risk of dementia, AD, accelerated cognitive decline, and poorer cognitive performance in older adults.

Highlights

• An increased estimated pulse wave velocity (ePWV) was associated with incident dementia, Alzheimer's disease, and accelerated cognitive decline in a rural Chinese older population.
• A higher ePWV at baseline was associated with lower scores of global cognition and multiple cognitive domains at the 4-year follow-up.
• An increased ePWV may be a risk factor for dementia and accelerated cognitive deterioration in aging.