Département de gériatrie, CHRU-Nancy, Nancy, France ; Inserm U1116, Faculté de médecine, Nancy, France ; Université de Lorraine, Nancy, France
Arterial stiffness is an independent predictor of morbidity (infarction, fatal stroke) and cardiovascular mortality, especially in elderly, hypertensive patients with pre-terminal renal insufficiency and in coronary disease patients. The gold standard of its measurement is the pulse wave velocity assessment. The important increase in arterial stiffness that occurs during midlife is associated with the occurrence of severe cardiovascular and cerebrovascular events and also cognitive decline. The causal relationship between stiffening of the arterial tree and cognitive disorders has not yet been clearly established, however, many studies show a relationship between higher levels of aortic stiffness and poorer performance on cognitive memory tests. Arterial stiffness is associated with microvascular alterations, with an increase in microvascular resistance, an increase in leukoaraisosis and also medial temporal lobe atrophy. These damages contribute to dementia pathogenesis (including Alzheimer's disease) and confirm the importance of early detection and management of arterial stiffness increase.