Excess pressure but not pulse wave velocity is associated with cognitive function impairment: a community-based study

Area of Science:

• Cardiovascular Physiology
• Neuroscience
• Gerontology

Background:

• Carotid-femoral pulse wave velocity (cf-PWV), a measure of distal aortic stiffness, shows inconsistent links to cognitive function.
• Excess pressure, derived from arterial reservoir-excess pressure analysis, may reflect proximal aortic pulsatile load.
• The study investigated the association between increased excess pressure and cognitive impairment in community-dwelling adults.

Purpose of the Study:

• To determine if elevated excess pressure is associated with impaired cognitive function in community adults.
• To compare the association of excess pressure with cognitive function against cf-PWV.
• To identify determinants of excess pressure and cf-PWV.

Main Methods:

• 992 community participants (mean age 67.3 years) without cerebrovascular disease or dementia were assessed.
• Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA).
• Arterial reservoir and excess pressure, arterial stiffness, and wave reflections were measured via carotid tonometry and aortic Doppler flowmetry.

Main Results:

• Participants with low MoCA scores had higher excess pressure integral (XSPI) and percentage XSPI.
• XSPI and percentage XSPI, but not cf-PWV, were significantly associated with low MoCA scores in multivariable analyses.
• Forward pressure amplitude (Pf) and characteristic impedance (Zc) were key determinants of XSPI, while age determined cf-PWV.

Conclusions:

• Excess pressure, reflecting proximal aortic hemodynamics, is significantly associated with cognitive impairment in middle-aged and elderly adults.
• These findings highlight the importance of proximal aortic pulsatile load in cognitive health.
• Excess pressure may serve as a valuable biomarker for cognitive decline risk.