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Ankle-brachial index rather than brachial-ankle pulse wave velocity is associated with cognitive function in older

Kai Zheng1,2, Chuanjun Huang1,2, Yue Wang1,2

  • 1Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.

Annals of Medicine
|May 19, 2026
PubMed

Insights

Cognitive impairment in hemodialysis patients is linked to arterial stiffness. Lower ankle-brachial index (ABI), indicating lower limb blood vessel blockage, is associated with declining cognitive function in these patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Neurology

Background:

  • Hemodialysis (HD) patients frequently experience cognitive impairment.
  • Arterial stiffness is a potential contributing factor to cognitive decline in HD patients.
  • The specific relationship between arterial stiffness measures and cognitive performance in HD patients requires further investigation.

Purpose of the Study:

  • To examine the association between cognitive impairment and arterial stiffness in hemodialysis patients.
  • To investigate the correlation between brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) with cognitive function.

Main Methods:

  • A cross-sectional study involving 889 HD patients from seven centers in China.
  • Arterial stiffness was assessed using baPWV and ABI.
  • Cognitive function was evaluated using the Mini-Mental State Examination (MMSE).

Main Results:

  • 16.4% of HD participants exhibited cognitive impairment.
  • Patients with cognitive impairment had higher baPWV and lower ABI compared to those with normal cognitive function (p < 0.05).
  • The highest quartile of ABI was significantly associated with lower odds of cognitive impairment (OR: 0.576; 95% CI: 0.335-0.989).

Conclusions:

  • Lower ABI, an indicator of lower limb arterial blockage, is significantly associated with cognitive impairment in hemodialysis patients.
  • These findings suggest ABI as a potential biomarker for cognitive decline in HD populations.
  • Further research should explore interventions targeting arterial stiffness to improve cognitive outcomes in HD patients.
Abstract

Keywords:
Arterial stiffnesschronic kidney diseasecognitive functionhemodialysis

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