Interactive effects of arterial stiffness and Alzheimer's disease risk on cognitive decline in older adults without dementia.

Among individuals who are amyloid biomarker-positive or apolipoprotein E (APOE) ε4 carriers, arterial stiffness reflected by higher pulse wave velocity (PWV) has been associated with lower cognition cross-sectionally. Less is known about longitudinal associations. The sample included 152 older adults without dementia. Linear mixed-effects models examined if PWV (1) was associated with cognitive decline and (2) interacted with APOE ɛ4 status or cerebrospinal fluid (CSF) amyloid positivity on cognitive decline. PWV was not associated with cognitive decline across any domains. There was an interaction between PWV and CSF amyloid positivity on executive function (p = 0.038) and language (p = 0.047), such that higher PWV was related to faster decline in CSF amyloid-positive individuals relative to amyloid-negative individuals. PWV did not interact with APOE ɛ4 status on cognitive decline. PVW, as a marker of vascular risk, may adversely modify the trajectory of cognitive decline, particularly in amyloid-positive individuals. Pulse wave velocity (PWV) was not associated with cognitive decline in any domain. Amyloid status moderated the effect of PWV on executive function and language decline. Higher PWV was associated with faster decline among amyloid-positive individuals. There was no interaction between PWV and apolipoprotein E (APOE) ε4 status on cognitive decline.