Association Between Estimated Pulse Wave Velocity and Cognitive Performance in Older Black and White Adults in NHANES

Abstract

Background: Aging-associated cognitive decline is greater in non-Hispanic Black (NHB) adults than non-Hispanic White (NHW) adults. An important risk factor for cognitive decline with aging is arterial stiffening, though the importance to racial variation remains poorly understood. Objective: We examined the association of an estimate of arterial stiffness with cognitive function in a bi-racial sample of 60–85-year-old adults (N = 3,616, 26.5% NHB) enrolled in the National Health and Nutrition Examination Survey (NHANES) between 1999–2002 and 2011–2014. Methods: As a measure of vascular aging, pulse wave velocity was estimated (ePWV) using an equation incorporating age and mean arterial pressure and expressed as m/s. Using the digit symbol substitution test (DSST), cognitive function was expressed as the number of correctly matched symbols (out of 133) within 120 s. Linear regression models examined associations between ePWV and DSST. Results: In models that adjusted for sex, education, smoking, body mass index, history of cardiovascular disease, and hypertension, ePWV was inversely associated with DSST score in NHB adults (β= –3.47, 95% CI = –3.9 to –3.0; p < 0.001) and NHW adults (β= –3.51, 95% CI = –4.4 to –2.6; p < 0.001). Conclusion: ePWV is inversely associated with a measure of cognitive function in older Black and White adults. ePWV may be a useful measure of vascular aging that can offer insight into cognitive aging.