Healthy Vascular Aging is Associated with Higher Cognitive Function in Middle‐Aged and Older Adults
Authors: Rossman Matthew J , Rosenberg Hannah L. , Seals Douglas R. , Craighead Daniel H. 
Published: June 2021

Healthy vascular aging (HVA), defined as an absence of both hypertension (JNC7 guidelines) and age‐related aortic stiffening (i.e., carotid‐femoral pulse wave velocity [CFPWV] <7.6 m/s) is associated with reduced risk of cardiovascular disease in adults ≥50 years old (1). Increasing evidence suggests better cardiovascular health is associated with reduced risk for cognitive impairment and dementia, but whether HVA status is associated with cognitive function in otherwise healthy middle‐aged and older (MA/O) adults is unknown. We tested the hypothesis that MA/O adults with HVA would have better cognitive function than those without HVA. Subjects from our laboratory database (n=105; age 64±1 years; 48 M/57 F) who were free of clinical disease were grouped as those with HVA vs. those not meeting HVA criteria because of elevated aortic stiffness alone (Stiffness, CFPWV >7.6 m/s) or both elevated aortic stiffness and hypertension (Stiffness+HTN, CFPWV >7.6 m/s and blood pressure >140/90 mmHg or prescribed antihypertensive medication). Processing speed and executive function were measured using Trail Making Tests (TMT) Part‐A and ‐B, respectively. Additional subdomains of cognitive function were assessed with the NIH Toolbox Cognition‐Battery, including measures of total, fluid (e.g., episodic and working memory) and crystallized (e.g., verbal cognition) cognitive ability in a subset of subjects (n=77). Time to complete TMTb was lower in the HVA group compared to the Stiffness+HTN group (53±3 sec vs. 75±8 sec, p=0.003), suggesting better executive function with HVA. Total cognition and fluid cognition composite scores from the NIH Toolbox were higher in the HVA group compared to both the Stiffness and Stiffness+HTN groups (total cognition: 128±3 AU vs. 118±2 AU vs. 110±3 AU, p<0.05; fluid cognition: 106±3 AU vs. 101±2 AU vs. 96±3 AU, p<0.05), whereas the crystallized cognition composite score was higher in the HVA group vs. the Stiffness+HTN group (134±3 AU vs. 123±4 AU, p=0.007). Multiple linear regression analysis to control for age, sex, body composition, education, physical activity and blood chemistries revealed that HVA status was an independent predictor of executive function (TMTb score) as well as the total, fluid, and crystalized cognition composite scores from the NIH Toolbox. Lastly, re‐analysis of our data following re‐classification of subjects using the new American College of Cardiology/American Heart Association blood pressure guidelines (i.e., the revised threshold for stage‐1 hypertension of >130/80 mmHg) produced similar results; differences from the original analysis included HVA status‐related group differences in processing speed (TMTa score), and that HVA status was not associated with crystallized composite score. Collectively, our findings support the hypothesis that MA/O adults with HVA exhibit higher cognitive function compared to those without HVA.Support or Funding InformationNIH F32 AG053009, K01 DK115524, T32 AG000279 and T32 DK007135; AHA 18POST33990034This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.