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Basic Science and Pathogenesis.

Enid Swatson1, Whitney Wharton1, Danielle D Verble1

  • 1Emory University, Atlanta, GA, USA.

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Cardiovascular disease markers like hypertension and arterial stiffness are linked to poorer cognitive function in aging adults. These associations may differ across racial groups, highlighting the need for diverse research and personalized health strategies.

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Area of Science:

  • Neurology
  • Cardiology
  • Gerontology

Background:

  • Cardiovascular disease (CVD) is a major health concern for older adults in the US.
  • Hypertension, high cholesterol, and lifestyle factors are risk factors for both CVD and Alzheimer's disease (AD).
  • Chronic hypertension contributes to arterial stiffness and impaired cerebral blood flow, linked to cognitive decline.

Purpose of the Study:

  • To investigate the relationship between vascular health and cognitive function in a diverse cohort of cognitively normal individuals at risk for AD.
  • To examine how arterial stiffness and blood pressure relate to various cognitive domains.

Main Methods:

  • Utilized data from the E2 and ASCEND longitudinal studies of middle-aged to older adults with a parental history of AD.
  • Administered a cognitive battery assessing verbal fluency, visuospatial ability, and executive function.
  • Measured pulse wave velocity (PWV) for arterial stiffness and aortic blood pressures, followed by linear regression analyses.

Main Results:

  • In non-Hispanic White (NHW) participants, higher PWV correlated with poorer performance in verbal fluency and memory tasks.
  • Systolic blood pressure was linked to reduced performance in digit span for both NHW and Black/African American (B/AA) individuals.
  • Diastolic blood pressure and pulse pressure showed associations with cognitive performance in NHW participants, but not consistently in B/AA individuals.

Conclusions:

  • Elevated blood pressure and arterial stiffness are associated with diminished cognitive function across multiple domains.
  • Vascular and cognitive relationships may vary significantly by race, indicating that a universal approach to diagnosis and treatment is insufficient.
  • Future research must prioritize diverse populations to understand disease mechanisms and develop equitable prevention and treatment strategies.