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Sex Differences in the Relationship Between Arterial Stiffness and Cognitive Function in Older Adults

  • Elizabeth Dao
    Affiliations
    Department of Radiology, University of British Columbia (UBC), 2775 Laurel St., Vancouver V5Z 1M9, Canada

    Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada
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  • Cindy K. Barha
    Affiliations
    Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada

    Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada

    Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada
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  • Mij Santos
    Affiliations
    Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada
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  • Madison Welch
    Affiliations
    Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada

    Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada

    Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada
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  • Teresa Liu-Ambrose
    Correspondence
    Address correspondence to Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada.
    Affiliations
    Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada

    Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada

    Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada
    Search for articles by this author

      Highlights

      • Arterial stiffness is associated with cognitive impairment and dementia.
      • The course of arterial damage is sexually dimorphic.
      • Sex may moderate the association between arterial stiffness and cognitive function.
      • The effect of arterial stiffness on cognition may be stronger in males than females.
      • These results support sex-specific mechanisms in the evolution of cognitive aging.

      Abstract

      Objective

      To examine potential sex differences in the relationship between arterial stiffness and global cognitive function and executive functions.

      Methods

      Baseline data from 80 older adults were included from two randomized controlled trials (NCT02669394 and NCT02737878). Arterial stiffness was measured by carotid-femoral pulse wave velocity (cf-PWV). Cognitive function assessment included global cognition (Mini-Mental State Examination [MMSE]) and executive functions (set shifting [Trail Making Test Part B minus A], inhibition [Stroop Test], and working memory [Verbal Digit Span Backwards Test]). Separate statistical models were constructed to assess the effect of cf-PWV on each cognitive outcome for females and males. Each statistical model controlled for Framingham cardiovascular disease risk score and education.

      Results

      Higher cf-PWV was associated with impaired MMSE performance in males (β = -0.48; p = 0.018), but not females (p ≥ 0.389). For executive processes, higher cf-PWV was associated with impaired Trail Making Test Part B minus A (β = 0.56; p = 0.005) and Stroop Test (β = 0.59; p = 0.004) in males, but not in females (ps ≥ 0.108). cf-PWV was not significantly associated with Verbal Digit Span Forward minus Backward Test in males or females (ps ≥ 0.108).

      Conclusions

      Arterial stiffness is more strongly associated with cognitive impairment in males than females. These results further elucidate the interplay between vascular health and cognitive function by providing support for sex-specific mechanisms.

      Key Words

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