Brachial-Ankle Pulse Wave Velocity is Associated with Incident Dementia in Patients with Cerebral Small-Vessel Disease

• Published in: Journal of Atherosclerosis and Thrombosis Vol. 32; no. 1; pp. 58 - 69
• Main Authors: Kitagawa, Kazuo, Yoshizawa, Hiroshi, Hosoya, Megumi, Seki, Misa, Toi, Sono, Yamagishi, Sae
• Format: Journal Article
• Language: English
• Published: Japan Japan Atherosclerosis Society 01.01.2025
• Subjects: Aged; Ankle Brachial Index - methods; Arterial stiffness; Cerebral Small Vessel Diseases - complications; Cerebral Small Vessel Diseases - diagnosis; Cerebral Small Vessel Diseases - epidemiology; Cerebral Small Vessel Diseases - physiopathology; Cerebral small-vessel disease; Cognitive impairment; Dementia; Dementia - diagnosis; Dementia - epidemiology; Dementia - physiopathology; Female; Follow-Up Studies; Humans; Incidence; Japan - epidemiology; Magnetic Resonance Imaging - methods; Male; Middle Aged; Original; Prognosis; Pulse Wave Analysis - methods; Risk Factors; Vascular Stiffness; Japan; Cerebral small-vessel disease; Arterial stiffness; Cognitive impairment; Dementia
• ISSN: 1340-3478; 1880-3873; 1880-3873
• DOI: 10.5551/jat.65042

Aims: Increased arterial stiffness is associated with the severity of cerebral small-vessel disease (SVD) and may predict incident dementia. This study investigated the predictive value of brachial-ankle pulse wave velocity (ba-PWV) for dementia and cognitive decline.Methods: Data were obtained from a Japanese cohort of 478 patients who underwent ba-PWV measurement. Magnetic resonance imaging (MRI) was used to evaluate SVD severity. The Mini-Mental State Examination (MMSE) and the Japanese version of the Montreal Cognitive Assessment (MoCA-J) were used to assess the cognitive function. The primary outcome was the incidence of dementia. The secondary outcome was cognitive change during three years of follow-up.Results: The median age was 71 years old, 61% were men, and the median ba-PWV was 1787 cm/s. Dementia was diagnosed in 23 patients during a mean follow-up of 4.8 years. A Cox proportional hazard regression analysis revealed that the highest quartile (ba-PWV ≥ 2102 cm/s) was associated with a significantly higher risk of dementia than the first to third quartiles (ba-PWV ≤ 2099 cm/s) after adjusting for risk factors, the mean blood pressure, the MoCA-J score, and SVD severity (adjusted HR, 3.40; 95% CI, 1.24-9.34; P=0.018). Longitudinal cognitive changes in 192 patients indicated that ba-PWV was negatively related to changes in the MoCA-J score (r=-0.184, P=0.011). The decline in the MoCA-J score in the highest quartile was greater than that in the first to third quartiles after adjusting for risk factors, SVD severity, and baseline MoCA-J score (P=0.017).Conclusions: ba-PWV was associated with incident dementia and cognitive decline, independent of age, risk factors, the baseline cognitive function, and the SVD severity.