Prospective Study of Arterial Stiffness and Subsequent Cognitive Decline Among Community-Dwelling Older Japanese

Background: Brachial-ankle pulse wave velocity (baPWV) is inversely associated with cognitive function. However, it is not known whether baPWV predicts cognitive decline (CD) in later life. We examined whether or not baPWV is an independent risk marker of subsequent CD in a population of older Japanese. Methods: Among 982 adults aged 65 years or older who participated in a baseline survey, 526 cognitively intact adults (Mini-Mental State Examination [MMSE] score >= 24; mean [SD] age, 71.7 [5.6] years; women, 57.8%) were followed for a period of up to 5 years. Pulse wave velocity was determined using an automated waveform analyser. Cognition was assessed by the MMSE, and CD was defined as a decrease of two points or more on the MMSE. Results: During an average follow-up of 3.4 years, 85 participants (16.2%) developed CD. After controlling for important confounders, the odds ratios for CD in the highest and middle tertiles of baPWV, as compared with the lowest tertile, were 2.95 (95% confidence interval, 1.29-6.74) and 2.39 (95% confidence interval, 1.11-5.15), respectively. Conclusions: High baPWV was an independent predictor of CD in a general population of older adults and may be useful in the clinical evaluation of elders.