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Keywords:

  • cognition;
  • dementia;
  • arterial stiffness;
  • hypertension;
  • pulse wave velocity

Abstract

Background:  Although arterial stiffness has recently been confirmed as a predictor of cardiovascular disease, the association between arterial stiffness and cognitive decline is less clear.

Aim:  We performed a systematic review and meta-analysis to examine the evidence for large artery stiffness as a cause of cognitive decline and dementia.

Method:  Electronic databases were systematically searched until September 2011 for studies reporting on the longitudinal relationship between any validated measure of large artery stiffness and cognitive decline or dementia. Meta-analysis was performed on four studies investigating the association between aortic pulse wave velocity and a decline in Mini-Mental State Examination scores.

Results:  Six relevant longitudinal studies were located, conducted over an average of 5 years follow up. Arterial stiffness was predictive of cognitive decline in five/six studies. In meta-analysis, higher aortic stiffness predicted lower Mini-Mental State Examination scores within the sample (β=−0.03, 95% confidence interval (CI): −0.06 to 0.01, n= 3947), although studies were not all homogeneous, and statistical heterogeneity was present (I2= 71.9%, P= 0.01). Removal of one study with a relatively younger cohort and lower median aortic stiffness found higher aortic stiffness to significantly predict cognitive decline (β=−0.04, 95% CI: −0.07 to −0.01, n= 3687) without evidence of heterogeneity (I2= 9.5%, P= 0.33). There was little research investigating the effects of aortic stiffness on the development of dementia.

Conclusion:  Aortic stiffness was found to predict cognitive decline in both qualitative review and quantitative analysis.