Pulse wave velocity as a marker of cognitive impairment in the elderly

Carotid-femoral pulse wave velocity (PWV), an index of large artery stiffness, is a good proxy of arterial aging and also an independent marker of cardiovascular disease. A consistently growing number of studies has shown a significant inverse association of arterial aging and cognitive function: the greater the PWV, the lower the cognitive performance (and the greater its decline over time)-regardless of heterogeneity in study populations, sample size, and measure of cognitive functions adopted in each study. Therefore the epidemiological evidence and the biological plausibility require adoption of strategies to foster the routine measurement of PWV and cognitive function measurements in each and every older subject, particularly those at higher cardiovascular risk. Consistently, limited available healthcare resources should be progressively shifted from a sterile differential diagnosis between Alzheimer-type and vascular dementia to interventions aimed to reduce PWV and, thus, to prevent dementia before its onset or to decrease its rate of progression.