Abstract 14119: Aortic Stiffness is Associated With Cognitive Decline and Cardiovascular Disease Manifestation in Cancer Survivors

Abstract

Introduction: Cancer survivors experience a high prevalence of cognitive deficits and risk of CVD. Aortic stiffening, which increases following cancer diagnosis, inhibits pulsatile flow damping and potentiates microvascular damage within the cerebral circulation, which may contribute to associations observed between stiffness, cognitive decline, and mild cognitive impairment (MCI) in the general population. However, there is a paucity of evidence on the association between arterial stiffness and cognitive decline among cancer survivors. Methods: We evaluated dementia-free cancer survivors in the Framingham Original and Offspring Cohorts (n=277, 80±12.3 years old, 56.7% women, 9.3±8.8 years from first diagnosis) with carotid-femoral pulse wave velocity (cfPWV) measurements. Over a mean follow-up of 7.7±3.9 years, the Mini-Mental State Examination (MMSE; global cognitive function) and neuropsychological exams (NP; executive function, learning and memory) were completed. We noted cognitive decline and incident MCI per clinically relevant standards. We used linear and logistic regression models to determine the relationship between cfPWV and cognitive decline/MCI. Cox Regression related cfPWV and cognitive function to the risk of CVD. Multivariate models were adjusted for age, sex, depressive symptoms, and traditional CVD risk factors. Results: cfPWV was significantly associated with the rate of decline for global cognitive function (ΔMMSE). Higher cfPWV was significantly associated with clinically defined MCI, denoted by an impaired MMSE (OR(95%CI): 9.2(2.5-33.5)) and NP score (4.3 (1.4-13.0)) in univariate logistic models. We observed a 3.4 times higher risk of CVD in cancer survivors with high cfPWV (HR(95%CI): 3.45 (1.04-11.66)) in the final model. Changes in cognitive function were not associated with CVD. Conclusion: Our findings suggests an association between aortic stiffness, future cognitive decline, and an increased risk of CVD in a diverse cohort of cancer survivors. Our findings support the potential adverse consequences of a stiffening arterial vasculature following cancer diagnosis; specifically those related to cognitive function and long-term CVD outcomes.