Introduction: Microvascular endothelial dysfunction may be implicated in the etiology of cognitive decline. Yet, current data on this association are inconsistent.
Hypothesis: More impaired endothelial function (EF) is related to worse cognitive performance in adults.
Methods: In the ELSA-Brasil baseline examination, 1,521 non-demented participants underwent peripheral arterial tonometry (PAT) to quantify microvascular EF [PAT-ratio and mean baseline pulse amplitude (BPA)] and cognitive tests covering the domains of memory, semantic and phonemic fluency, and executive function. Linear regression and generalized linear models were used to assess the association between EF, global and specific cognitive performance. Adjustments were made for sex, age, level of education, alcohol intake, BMI, systolic blood pressure, antihypertensive use, diabetes mellitus, total/HDL cholesterol, smoking, prevalent cardiovascular disease, and use of neuroleptics.
Results: In unadjusted analyses, more impaired PAT measures was associated with worse global cognitive performance [difference per unit increase, BPA: -0.07 (95%CI: -0.11; -0.03), PAT-ratio: 0.11 (95%CI: 0.01; 0.20)]. Specifically, BPA and PAT-ratio were related to worse learning memory [difference per unit increase, BPA: -0.54 (95%CI: -0.78; -0.31), PAT-ratio: 0.96 (95%CI: 0.43; 1.48)], delayed memory [difference per unit increase, BPA: -0.26 (95%CI:-0.37; -0.14), PAT-ratio: 0.51 (95%CI: 0.25; 0.77)], and semantic fluency [difference per unit increase, BPA: -0.46 (95%CI:-0.77; -0.14), PAT-ratio: 0.72 (95%CI: 0.01; 1.43)]. However, adjustments for age, sex and level of education rendered the associations statistically non-significant.
Conclusions: The association between microvascular EF and cognition are explained by age, sex, and educational level. Measures of microvascular endothelial function may therefore be of limited value with regard to preclinical cognitive deficits.