Associations between Estimates of Arterial Stiffness and Cognitive Functioning in Adults with HIV

Abstract

Background: Vascular aging, a precursor of arterial stiffness, is associated with neurocognitive impairment (NCI) and cardiovascular disease (CVD). Although HIV is associated with rapid vascular aging, it is unknown whether arterial stiffness mediates changes in cognitive function. We explored whether estimated markers of vascular aging were associated with NCI indices in HIV-positive individuals. Methods: This study was a secondary analysis of an observational study. Neurocognitive functioning was assessed using a battery of seven domains (verbal fluency, executive functioning, speed of information processing, attention/working memory, memory [learning and delayed recall], and motor skills). Vascular aging was assessed using estimated markers of arterial stiffness (i.e., estimated pulse wave velocity [ePWV], pulse pressure, and vascular overload index [VOI]). A multivariable regression adjusted for demographics, CVD risk factors, and HIV-clinical variables was used to examine the association between vascular aging and NCI outcomes. Results: Among 165 adults with HIV, the mean age was 51.5 ± 6.9 years (62% men and 83% African American/Black or Other). In fully adjusted models, an increase in ePWV and pulse pressure was associated with lower T scores in Learning (-2.95 [-5.13, -0.77]) and Working Memory (-2.37 [-4.36, -0.37]), respectively. An increase in VOI was associated with lower T scores in Working Memory (-2.33 [-4.37, -0.29]) and Learning (-1.85 [-3.49, -0.21]). Conclusions: Estimated markers of arterial stiffness were weakly associated with neurocognitive functioning, suggesting that vascular aging may have a role in cognitive decline among PWH.