Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Arterial Stiffness Major Risk Factor for Dementia

Neurology; ePub 2018 Mar 16; Hughes, et al

Arterial stiffness, measured by pulse wave velocity (PWV), is an emerging risk factor for dementia through its repeated relationships with cognition, cerebral small vessel disease (cSVD), and fibrillar β-amyloid (Aβ) deposition in the brain, a recent study found. The Atherosclerosis Risk in Communities (ARIC)-Neurocognitive Study collected detailed cognitive testing for adjudication of dementia and mild cognitive impairment (MCI), brain MRI, and arterial stiffness by PWV (carotid-femoral [cfPWV] and heart-carotid [hcPWV]). The ARIC-PET ancillary study added Aβ imaging using florbetapir to obtain standardized uptake volume ratios and defined global Aβ-positivity as standardized uptake volume ratio >1.2. Researchers found:

  • Among the 320 ARIC-PET participants (76 [5] years, 45% black, 27% MCI), greater central stiffness (hcPWV) was associated with greater Aβ deposition.
  • Greater central stiffness (cfPWV) was significantly associated with having lower brain volumes in Alzheimer disease-susceptible regions (in mm3, β = −1.5 [0.7 SD]) and high white matter hyperintensity burden.
  • Furthermore, cfPWV was associated with a higher odds of concomitant high white matter hyperintensity and Aβ-positive scans.

Hughes TM, Wagenknect LE, Craft S, et al. Arterial stiffness and dementia pathology. Atherosclerosis Risk in Communities (ARIC)-PET Study. [Published online ahead of print March 16, 2018]. Neurology. doi:10.1212/WNL.0000000000005259.