Association of vascular health with motor and cognitive function in people with prodromal Alzheimer’s disease

Vascular dysfunction has been proposed as a contributor to age-related changes in movement and cognition; however, its associations with functional outcomes in older adults with amnestic mild cognitive impairment (MCI), clinically consistent with prodromal Alzheimer’s disease (pAD), remain unclear. This cross-sectional study analyzes baseline data from 73 older adults with amnestic MCI (mean age 74.6 ± 7.1 years). Vascular health is assessed using pulse wave velocity (PWV), aortic augmentation index (AIx), central mean arterial pressure (MAP), and subendocardial viability ratio (SEVR%).

Standardized assessments evaluate cognitive, motor, and motor–cognitive performance. Multivariable regression analyses are performed, adjusting for age, sex, ethnicity, and antihypertensive medication use. A higher PWV is linked to poorer balance performance (β = −0.375, p = 0.025).

Additionally, a higher SEVR% is associated with lower D-KEFS Inhibition-Switching performance (β = −0.053, p = 0.030). AIx is related to scores on the Montreal Cognitive Assessment (β = −0.079, p = 0.050). However, no statistically significant associations are observed between vascular measures and motor–cognitive outcomes.

Furthermore, sex is significantly associated with both AIx (p = 0.038) and SEVR% (p = 0.045). Vascular measures are selectively associated with balance and specific executive functions in older adults with amnestic MCI. Vascular health, including arterial stiffness, may be a relevant correlate of early functional changes in pAD.

Future longitudinal studies are needed to clarify the direction and clinical significance of these associations. As people age, problems with blood vessels can affect both movement and cognitive function, but the link between these changes in the early stages of Alzheimer’s disease (AD) remains unclear. In this study, we explored whether blood vessel health and arterial stiffness are linked to balance, movement, and cognitive abilities among older adults in the early stage of AD.

We found that individuals with stiffer arteries had poorer balance and that measures of blood vessel function were linked to performance on tasks requiring planning and attention. Overall, these results suggest that blood vessel health may play an important role in abilities such as balance and cognition in this population. Larger studies are needed to confirm these findings.