A hallmark of vascular aging, central arterial stiffness is the primary determinant of hypertension in older adults and an important predictor of cardiovascular events and mortality. Few studies of older adults have evaluated the longitudinal association of arterial stiffness with cognitive and physical declines, two common consequences of vascular disease. We sought to characterize the relationships among aortic pulse wave velocity (PWV), a measure of central arterial stiffness, cognitive and physical declines and mortality risk among community-dwelling older adults participating in the Health, Aging and Body Composition (Health ABC) study. In an analysis of the Health ABC Cognitive Vitality Substudy, poorer performances in several cognitive domains were associated with accelerated gait speed decline, consistent with a shared cerebrovascular pathogenesis underlying cognitive and physical declines in aging. A second analysis of the substudy identified PWV as a predictor of longitudinal decline in psychomotor speed; this domain-specific association may reflect a vulnerability of the deep white matter to cerebral microvascular disease in the presence of aortic stiffness. In an analysis of the full Health ABC cohort, higher PWV was independently associated with slower gait at baseline and throughout the study period in participants with peripheral arterial disease (PAD), suggesting synergistic roles of arterial stiffness and PAD in mobility decline. Finally, in the full cohort rates of decline in the Modified Mini-Mental State Exam (3MS) and gait speed predicted mortality independent of each other, baseline performance and risk factors, demonstrating a prognostic value for repeated assessments of both cognitive and physical performance in initially well-functioning older adults. The public health relevance of these findings is the potentially clinically important influence of central arterial stiffness to both cognitive and physical function, two central facets of successful aging.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-03152010-174843 |
| Date | 28 June 2010 |
| Creators | Watson, Nora L |
| Contributors | Caterina Rosano, Susan Hardy, Anne Newman, Robert Boudreau, Kim Sutton-Tyrrell |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-03152010-174843/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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