Estimated pulse wave velocity associated with cognitive phenotypes in a rural older population in China: A cohort study
Jiahui Li, Yifei Ren, Lidan Wang, Xinrui Zou, Xueran Ding, Tingting Hou, Qinghua Zhang, Shi Tang, Xiaojuan Han, Lin Song, Yajun Liang, Yongxiang Wang, Lin Cong, Yifeng Du, Chengxuan Qiu
Abstract
INTRODUCTION: To examine the longitudinal association between estimated pulse wave velocity (ePWV) and cognitive phenotypes in a rural Chinese older population. METHODS: This population-based study included 1857 dementia-free participants (age ≥60 years) who were examined in 2014 and followed in 2018. ePWV was calculated using age and mean blood pressure (MBP). Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and neuropsychological tests. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Data were analyzed using Cox proportional-hazards models, linear regression models, and restricted cubic spline (RCS) curves. RESULTS: Per 1-m/s increase in ePWV was associated with an adjusted hazard ratio (HR) (95% confidence interval [CI]) of 1.51(1.30-1.75) for dementia and 1.58(1.33-1.89) for Alzheimer's disease (AD), and with an MMSE score decline (adjusted β-coefficient = -0.36; 95% CI = -0.52 to -0.21). A nonlinear association was observed between baseline ePWV and follow-up cognitive scores. DISCUSSION: A higher ePWV is associated with an increased risk of dementia, AD, accelerated cognitive decline, and poorer cognitive performance in older adults. HIGHLIGHTS: An increased estimated pulse wave velocity (ePWV) was associated with incident dementia, Alzheimer's disease, and accelerated cognitive decline in a rural Chinese older population. A higher ePWV at baseline was associated with lower scores of global cognition and multiple cognitive domains at the 4-year follow-up. An increased ePWV may be a risk factor for dementia and accelerated cognitive deterioration in aging.