Associations of arterial stiffness and cognitive function with physical fitness in patients with chronic stroke

Objective: To determine whether arterial stiffness is associated with cognitive function after adjustment for physical fitness in patients with chronic stroke. Methods: Cross-sectional analyses were conducted in 102 patients with chronic stroke who participated in an exercise rehabilitation programme. Carotid femoral pulse wave velocity and augmentation index were measured as indices of arterial stiffness and central systolic loading. Cognitive function was assessed with the Mini Mental State Examination. Parameters of physical fitness included the 6-min walk test, flexibility, balance, and muscle strength tests. Results: Carotid femoral pulse wave velocity was significantly associated with Mini Mental State Examination (r = -0.45, p < 0.01) and parameters of physical fitness (r = -0.45∼ -0.55, p < 0.01, all). Mini Mental State Examination was significantly associated with parameters of physical fitness (r = 0.32∼0.46, p < 0.01, all). In multivariable linear regression models, carotid femoral pulse wave velocity was inversely associated with Mini Mental State Examination after adjustment for multiple risk factors (beta = -0.33, p = 0.01). However, the association was attenuated and became nonsignificant after additional adjustment for physical fitness (beta = -0.11, p = 0.39). Conclusion: Arterial stiffness measured by carotid femoral pulse wave velocity is associated with cognitive function in patients with chronic stroke, but not after adjustment for physical fitness. Maintaining appropriate levels of physical fitness may have a favourable effect on both vascular and cognitive function in patients with stroke.