Arterial stiffness and cognitive decline in well-functioning older adults.
Arterial stiffness and cognitive decline in well-functioning older adults.
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DOI：
10.1093/gerona/glr119
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发表时间：
2011-12
期刊：
影响因子：
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通讯作者：
N. Watson;K. Sutton-Tyrrell;C. Rosano;R. Boudreau;Susan E. Hardy;E. Simonsick;S. Najjar;L. Launer;K. Yaffe;Hal Atkinson;S. Satterfield;A. Newman
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文献类型：
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作者：
N. Watson;K. Sutton-Tyrrell;C. Rosano;R. Boudreau;Susan E. Hardy;E. Simonsick;S. Najjar;L. Launer;K. Yaffe;Hal Atkinson;S. Satterfield;A. Newman
背景：与高血压和其他血管危险因素无关的老年中央动脉硬化可能导致脑微血管疾病。很少有老年人的研究评估了中央动脉僵硬与纵向认知能力下降的关系。方法：我们评估了552名健康、衰老和身体组成（Health ABC）研究认知活力亚研究（平均年龄±SD = 73.1±2.7岁，男性48%，黑人42%）参与者的主动脉脉冲波速度（厘米每秒）与认知功能和衰退的关系，这是衡量中心动脉硬度的一种指标。在基线时通过多普勒记录颈动脉和股动脉脉冲波形评估主动脉脉冲波速度。总体认知功能、言语记忆、精神运动和知觉速度在6年内进行评估。结果：经人口统计学、血管危险因素和慢性疾病校正后，主动脉脉搏波速度（389 cm/s）每高1 SD与认知功能差相关：整体功能-0.11 SD (SE = 0.04, p < 0.01)，精神运动速度-0.09 SD (SE = 0.04, p = 0.03)，感知速度-0.12 SD （SE = 0.04, p < 0.01）。较高的主动脉脉波速度也与精神运动速度的较大下降有关，定义为比平均变化大于1个标准差（优势比= 1.42[95%置信区间= 1.06,1.90]），但与语言记忆或整体功能、语言记忆或感知速度的纵向下降无关。结果与每项认知测试下降的混合模型一致。结论：在功能良好的老年人中，中枢动脉僵硬可能导致独立于高血压和其他血管危险因素的认知能力下降。
BACKGROUND Stiffness of the central arteries in aging may contribute to cerebral microvascular disease independent of hypertension and other vascular risk factors. Few studies of older adults have evaluated the association of central arterial stiffness with longitudinal cognitive decline. METHODS We evaluated associations of aortic pulse wave velocity (centimeters per second), a measure of central arterial stiffness, with cognitive function and decline in 552 participants in the Health, Aging, and Body Composition (Health ABC) study Cognitive Vitality Substudy (mean age ± SD = 73.1 ± 2.7 years, 48% men and 42% black). Aortic pulse wave velocity was assessed at baseline via Doppler-recorded carotid and femoral pulse waveforms. Global cognitive function, verbal memory, psychomotor, and perceptual speed were evaluated over 6 years. RESULTS After adjustment for demographics, vascular risk factors, and chronic conditions, each 1 SD higher aortic pulse wave velocity (389 cm/s) was associated with poorer cognitive function: -0.11 SD for global function (SE = 0.04, p < .01), -0.09 SD for psychomotor speed (SE = 0.04, p = .03), and -0.12 SD for perceptual speed (SE = 0.04, p < .01). Higher aortic pulse wave velocity was also associated with greater decline in psychomotor speed, defined as greater than 1 SD more than the mean change (odds ratio = 1.42 [95% confidence interval = 1.06, 1.90]) but not with verbal memory or longitudinal decline in global function, verbal memory, or perceptual speed. Results were consistent with mixed models of decline in each cognitive test. CONCLUSIONS In well-functioning older adults, central arterial stiffness may contribute to cognitive decline independent of hypertension and other vascular risk factors.