Association of Central Arterial Stiffness and Pressure Pulsatility with Mild Cognitive Impairment and Dementia: The Atherosclerosis Risk in Communities Study-Neurocognitive Study (ARIC-NCS)

Article type: Research Article

Authors: Meyer, Michelle L.^{a; *} | Palta, Priya^a | Tanaka, Hirofumi^b | Deal, Jennifer A.^c | Wright, Jacqueline^d | Knopman, David S.^e | Griswold, Michael E.^f | Mosley, Thomas H.^g | Heiss, Gerardo^a

Affiliations: [a] Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA | [b] Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA | [c] Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA | [d] National Heart Lung and Blood Institute, Bethesda, MD, USA | [e] Department of Neurology, Mayo Clinic, Rochester, MN, USA | [f] Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA | [g] Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA

Correspondence: [*] Correspondence to: Michelle L. Meyer, PhD, MPH, Department of Emergency Medicine, University of North Carolina Chapel Hill, 170 Manning Drive, Chapel Hill, NC 27599-7594, USA. Tel.: +1 919 966 6539; Fax: +1 919 966 3049; E-mail: [email protected].

Abstract: Background: The association of central arterial stiffness and pressure pulsatility with mild cognitive impairment (MCI) and dementia is not well characterized in the population-based setting. Objective: The aim of this study was to quantify the cross-sectional association of arterial stiffness and pressure pulsatility with MCI and dementia among 4,461 older white and black adults from the population-based Atherosclerosis Risk in Communities Study-Neurocognitive Study. Methods: We used race-stratified multinomial logistic regression to evaluate associations of percentile cut points of carotid-femoral pulse wave velocity, central systolic blood pressure, central pulse pressure, and pulse pressure amplification with MCI and dementia versus no cognitive impairment. Results: Among whites, those with carotid-femoral pulse wave velocity or central systolic blood pressure ≥75th percentile had a higher prevalence of MCI compared to participants <75th percentile (conditional odds ratio (OR); 95% confidence interval (CI): 1.27 (1.02, 1.56) and 1.28 (1.04, 1.57), respectively) and those with central pulse pressure ≥75th percentile had a higher prevalence of MCI (OR 1.27 (95% CI: 1.03, 1.58)) and dementia (OR 1.76 (95% CI: 1.06, 2.92) compared to participants <75th percentile. Also among whites, those with pulse pressure amplification ≤25th percentile had a higher prevalence of dementia compared to participants >25th percentile (OR 1.65; (95% CI: 1.01, 2.70). Weaker associations were seen among black participants. Conclusion: Higher arterial stiffness and pulsatility were associated with MCI and dementia in white participants. Longitudinal characterization of the observed associations is warranted to assess whether arterial stiffness and pressure pulsatility predict MCI and dementia among older adults.

Keywords: Alzheimer’s disease, brain, cognition, dementia, mild cognitive impairment, pulse wave velocity

DOI: 10.3233/JAD-161041

Journal: Journal of Alzheimer's Disease, vol. 57, no. 1, pp. 195-204, 2017