Abstract TP084: Increased Carotid Distensibility Predicts Improved Cognitive Performance After 13 Years

Introduction: Carotid artery stiffness may contribute to cerebral small vessel disease and cognitive decline through impaired vascular compliance. Carotid distensibility, a direct measure of arterial stiffness, may serve as a vascular biomarker predicting latter cognitive performance. Hypothesis: We hypothesized that less carotid distensibility, increasing stiffness, would be associated with worse longitudinal cognitive performance. Methods: 313 GeneSTAR participants, relatives of patients with early-onset coronary artery disease, underwent carotid ultrasound and cognitive testing at baseline and again 13 years later. Linear mixed-effects models estimated the interaction between timepoint × carotid distensibility (z-scored), adjusting for age, sex, race, education, and systolic blood pressure, with random intercepts for family and participant. Cognitive outcomes included: Mini-Mental State Examination (MMSE); Digit Span Forward, Backward, Total; Delayed Word Recall 1, Short, long; Digit Symbol Substitution Test; Word Fluency; Grooved Pegboard Dominant Time; and Grooved Pegboard Non-Dominant Hand Time. Results: Greater carotid distensibility predicted better trajectories on Grooved Pegboard Dominant Hand Time (β = –8.95, p = 0.002), Digit Symbol Substitution total correct (β = 1.41, p = 0.013), Delayed Word Recall Long (β = 0.33, p = 0.024), and Delayed Word Recall Short (β = 0.30, p = 0.032). Positive trends were observed for MMSE (β = 0.21, p = 0.069), Grooved Pegboard Non-Dominant Hand Time (β = –6.60, p = 0.094), and Digit Span Total (β = 0.47, p = 0.104). (Table 1) Conclusions: Over 13 years of follow-up, greater carotid distensibility was associated with better performance on several cognitive tests. These findings suggest that carotid distensibility may protect against long-term cognitive decline and highlights the importance of carotid stiffness as a modifiable vascular risk factor in midlife.