P3‐215: Interrelationships Between Blood Vessel Function, Cognition and Fracture Risk

Estrogen decline and ageing are known to contribute to arterial stiffness, resulting in poor blood perfusion in bones and in the brain, thereby increasing the risk of bone loss and cognitive impairment. However, a link between cognitive decline and fracture risk resulting from poor arterial function has not been established. Using data collected from baseline visits in a 2-year resveratrol intervention trial, we investigated the influence of systemic and cerebral arterial function on cognition and future risk of fractures in postmenopausal women (n=146). Systemic arterial compliance of the large and small arteries was assessed with a Cardiovascular Profiler (HDI CR2000). Pulsatility index (PI), reflecting stiffness in the middle cerebral artery, was assessed using transcranial Doppler ultrasound. Attention, fluency, language, memory and visuospatial functions were assessed by Addenbrooke's Cognitive Examination-III. Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD) of the hip, from which the ten-year probability of sustaining a major osteoporotic fracture and hip fracture was estimated using the FRAX calculator. Systemic arterial stiffness was associated with higher PI (r=-0.278, P=0.002) and increased risk of osteoporotic fracture (r=-0.322, P<0.001). Higher PI was also associated with heightened risk of osteoporotic fracture (r=0.312, P<0.001) and with poorer verbal fluency (r=-0.280, P=0.001), but not with other domains. Poor verbal fluency was associated with future risk of osteoporotic fracture (r=-0.303, P<0.001) and hip fracture (r=-0.262, p=0.001). In our cohort, cerebrovascular stiffness is associated with poor cognition and increased osteoporotic and hip fracture risks. The latter might reflect the effect of systemic arterial stiffness on the diminished blood supply to bones. The association between poor cognition and future fracture risk warrants further investigation.