Key result
Higher pulse pressure linked to worse executive function, particularly in younger APOE ε4 carriers.
Why the study?
Pulse pressure may affect executive function, but whether this relationship is moderated by age and genetic risk for Alzheimer's disease remains unclear.
Is pulse pressure associated with worse executive function in older adults without dementia, and is this relationship moderated by age and APOE ϵ4 genotype?
Cross-Sectional (n=216)
Yes
Is pulse pressure associated with worse executive function in older adults without dementia, and is this relationship moderated by age and APOE ϵ4 genotype?
Effect estimate: β = 0.04
p-value: p=0.007
Higher pulse pressure is associated with worse executive function in older adults, an effect that may be exacerbated by genetic risk for Alzheimer's disease.
May support pulse pressure monitoring to preserve executive function; leaves open age and APOE moderation in older adults.
OBJECTIVES: Pulse pressure (PP) calculated as systolic minus diastolic blood pressure is a surrogate measure of arterial stiffness that may affect executive function; however, this relationship could be moderated by age and genetic risk for Alzheimer's disease (AD). We therefore examined relationships among PP, age, AD risk (i.e., APOE genotype) and executive function measured by the NIH Toolbox Cognition Battery (NIHTB-CB) in older adults. METHODS: PP was determined in 216 older adults without dementia (mean age: 77.5 ± 7.9 years, education: 16.8 ± 2.4 years, 55% women, 34.8% APOE ϵ4+) who were tested with the NIHTB-CB as part of the Advancing Reliable Measurement of Alzheimer's Disease and Cognitive Aging (ARMADA) study. RESULTS: = .005) across all participants. CONCLUSIONS: Arterial stiffness measured by PP in older adults is associated with worse performance on NIHTB-CB tests of executive function, working memory, and episodic sequence memory, particularly in younger APOE ϵ4 carriers. Arterial stiffness and AD risk may work synergistically in an age dependent manner to adversely affect cognition.
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Quiring et al. (2026) conducted a cross-sectional in Older adults without dementia (n=216). Pulse pressure was evaluated on List Sorting Working Memory score (PP x Age x APOE interaction) (β = 0.04, p=0.007). Higher pulse pressure was associated with worse performance on tests of executive function and working memory, particularly in younger APOE ε4 carriers (interaction β = 0.04, p = 0.007).
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