Arterial Stiffness is Correlated with Cognitive Decline Independent of Silent Brain Ischemia

Objective: Arterial stiffness is a measure of cerebrovascular disease. We analyzed the association between arterial stiffness, cognitions and silent brain ischemia. Methods: We performed a cross sectional study in 2055 neurologically normal subjects in brain checkup system. We estimated periventricular hyperintensity (PVH), white matter hyperintensity (WMH) and silent brain infarction (SBI) as silent brain ischemia in MRI with brachial-ankle pulse wave velocity (baPWV) as arterial stiffness. Kohs' block design test, Okabe's Intelligence Scale and frontal assessment battery (FAB) were assessed as measures of cognitive function. Results: The baPWV was higher in PVH+(grade 2 and 3) and WMH+(grade 3) groups than in PVH- and WMH- groups (p<0.01). The baPWV was also higher in SBI group than in non SBI group (p<0.001). The baPWV was inversely correlated with Kohs test (p<0.01, β=-0.066) and FAB test (p<0.01, β=-0.084) independently after adjusted for age, education level, presence of PVH, WMH and SBI. The middle and high tertiles of baPWV were not correlated with silent brain ischemia after adjusted for age, and vascular risk factors. Conclusions: The baPWV is not only a biomarker of arterial stiffness, but also index of cognitive impairment independent of silent brain ischemia.