A Scoping Review of the Complementary Feeding Practices and Early Eating Experiences of Children With Down Syndrome.

OBJECTIVE: Children with Down syndrome may experience more challenges in their early feeding and may be introduced to complementary foods comparatively later than typically developing (TD) children. This scoping review aimed to identify and synthesize the existing literature that describes feeding problems and early eating experiences relating to the period of complementary feeding for children with Down syndrome. METHODS: Scopus, PubMed, Medline, Web of Science, and PsycInfo were searched. Journal articles published between January 1991 and June 2022 that reported on the complementary feeding period with children with Down syndrome were included. RESULTS: Eighteen journal articles met the inclusion criteria. Children with Down syndrome were introduced to complementary foods later than TD children and progressed to more challenging food textures at a slower rate. Gross and fine motor skill delays and sensory difficulties contributed to secondary feeding problems such as difficulties chewing, biting, and reduced awareness of food on lips and tongue. Parents of children with Down syndrome reported exercising more caution and employing more controlling feeding practices compared to TD and had higher levels of concern regarding their child's weight. CONCLUSIONS: Guidelines and early feeding support specific to children with Down syndrome should be available before the first complementary foods are introduced and throughout this period. Feeding support should aim to address parental concerns and provide assistance when feeding problems occur, to minimize delays and encourage the optimum development of eating abilities. Future research should address the development of feeding problems during this period and explore possible interventions.

Relationships between feeding problems, eating behaviours and parental feeding practices in children with Down syndrome: A cross-sectional study.

BACKGROUND: Research investigating feeding problems in children with Down syndrome is scarce. This study investigated feeding problems, eating behaviours and parental feeding practices in children with Down syndrome (n = 40), and typically developing (TD) children of the same age and sex (n = 40). METHOD: Parents of children aged 6-months to 5-years in the UK completed questionnaires assessing their child's feeding problems and eating behaviours and parental feeding practices. RESULTS: For children with Down syndrome, feeding problems were: significantly greater than for TD children; negatively associated with breast milk duration and appetite during exclusive milk feeding; and positively associated with drinking more slowly. For both groups, feeding problems were significantly correlated with more food avoidant eating behaviours. CONCLUSIONS: This study provides new information about the relationships between feeding problems and eating behaviours in early development. Longitudinal research is needed to further investigate these relationships, so that effective support can be developed for families.

The relationship between sensory sensitivity, food fussiness and food preferences in children with neurodevelopmental disorders.

Heightened sensitivity to sensory information has been associated with food fussiness in both atypical and typical development. Despite food fussiness and sensory dysfunction being reported as common concerns for children with neurodevelopmental disorders, the relationship that exists between them, and whether they differ between disorders, has yet to be established. The current study aimed to examine sensory sensitivity as a predictor of food fussiness in three different neurodevelopmental disorders, whilst controlling for comorbidity amongst these disorders. Ninety-eight caregivers of children with Attention Deficit Hyperactivity Disorder (ADHD; n = 17), Tourette Syndrome (TS; n = 27), Autism Spectrum Disorder (ASD; n = 27), and typical development (TD; n = 27) were compared using parental reports of child food fussiness, food preferences and sensory sensitivity. Children with neurodevelopmental disorders were reported to have significantly higher levels of both food fussiness and sensory sensitivity, with children with ASD and TS also showing significantly less preference for fruit than children with TD. Importantly, higher levels of taste/smell sensitivity predicted food fussiness for all four groups of children. In addition, taste/smell sensitivity fully mediated the differences in food fussiness between each group of neurodevelopmental disorders compared to the TD group. The findings highlight that food fussiness is similar across these neurodevelopmental disorders despite accounting for comorbidity, and that greater sensitivity to taste/smell may explain why children with neurodevelopmental disorders are more likely to be fussy eaters.

The role of sensory sensitivity in predicting food selectivity and food preferences in children with Tourette syndrome.

Tourette syndrome (TS) is a neurodevelopmental disorder characterised by involuntary, repetitive and non-rhythmic motor and vocal tics. Despite suggestion that diet may affect tics, and the substantial research into children's diet, eating behaviours and sensory processing in comorbid disorders (e.g. ASD), research in TS is lacking. The present study examined differences between children with and without TS in parental reports of child selective eating, food preferences and sensitivity, and aimed to examine sensory sensitivity as a predictor of food selectivity outcomes in children with and without TS. Thirty caregivers of children with TS (M = 10 years 8 months [SD = 2.40]) and the caregivers of 30 age- and sex-matched typically developing (TD) children (M = 9 years 9 months [SD = 2.50]) completed the following measures online: Short Sensory Profile, Food Preference Questionnaire for Children, Child Eating Behaviour Questionnaire. Children with TS were reported to have significantly higher levels of food selectivity and sensory sensitivity, and less preference for fruit and vegetables than TD children. Importantly, while higher levels of overall sensory sensitivity predicted eating outcomes in the TS group, only sensitivity to taste/smell was found to be a predictor of food selectivity and preference for vegetables for both groups of children. The findings suggest that efforts to address food selectivity in children with TS may be enhanced by including strategies that address atypical sensory processing.

Infant temperament, maternal feeding behaviours and the timing of solid food introduction.

Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty-one women were recruited on low-risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire-Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez-faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression).

The Montreal Children's Hospital Feeding Scale: Relationships with parental report of child eating behaviours and observed feeding interactions.

Feeding problems are common, with implications for nutrition, growth and family stress, placing burden on primary care services. The Montreal Children's Hospital Feeding Scale (MCHFS) is a quick and reliable measure of feeding problems for clinical settings, but there is little examination of its relationship to commonly used research measures of parental feeding practice, child eating behaviour and observations of parent-infant interaction at mealtimes. We examined the relationships between the MCHFS, demographics and early feeding history, weight across the first year, parental report of feeding practices and child eating behaviours, and observations of maternal-infant feeding interaction at 1 year. The MCHFS, Comprehensive Feeding Practices Questionnaire (CFPQ) and Child Eating Behaviour Questionnaire (CEBQ) were completed by 69 mothers when their infants were 1-year-old (37 male, 32 female). Infant weight was measured at 1 week, 1 month, 6 months and 1 year. Mothers were observed feeding their infants at 1 year. The MCHFS was reliable (Cronbach's alpha = .90) and showed significant overlap with other measures of feeding and eating. Potential feeding problems were identified in 10 of the children (14%) reflecting similar rates in other community samples. Higher MCHFS scores were associated with lower birthweight and weight across the first year, greater satiety responsiveness, fussiness and slowness in eating, lower enjoyment of food and food responsiveness, and less observed infant food acceptance. Parents of infants with more feeding problems reported less encouragement of balance and variety in their children's diets. CONCLUSION: MCHFS showed good criterion validity with other parental report measures of eating and observations of mealtime interactions. MCHFS may be a useful tool for researching feeding problems in community samples.

Breastfeeding duration and its relation to weight gain, eating behaviours and positive maternal feeding practices in infancy.

Research examining the relationship between breastfeeding and infant weight has generated conflicting results. Few studies account for significant covariates and many suffer methodological problems such as retrospective self-report. The current study aimed to investigate relationships between breastfeeding duration, infant weight and eating and positive maternal mealtime behaviours, whilst overcoming many of the limitations of previous research. Eighty-one women on low-risk maternity units gave informed consent and were visited at home at 1-week, 1-, 6- and 12-months postpartum. Infants included 45 males and 36 females (mean birth-weight 3.52 kg [SD 0.39]). Mothers and infants were weighed and measured and feeding information was recorded at each visit. Infant weight was converted to a standard deviation score (SDS), accounting for age and sex. Mothers reported infant eating behaviours at 12-months using the Children's Eating Behaviour Questionnaire and were observed feeding their infants solid food at home at 6- and 12-months. Partial correlations (covariates: maternal age, education, BMI, smoking during pregnancy, household income, infant birth weight SDS and age introduced to solid foods) revealed negative associations between breastfeeding duration and 1- to 6- and 1- to 12-month weight gain, and 6- and 12-month weight. Breastfeeding duration was also associated with a slower rate of infant eating and greater observed maternal vocalisations, appropriateness and sensitivity. Results support a dose-response relationship between breastfeeding and infant weight and suggest that breastfeeding may encourage the development of obesity-protective eating behaviours through learning to attend to internal hunger and satiety signals. Future research should investigate whether relationships between slowness in eating and weight extend to satiety responsiveness after infancy.

Practical applications of physical activity for successful cognitive aging.

As patients lose cognitive function, they lose autonomy and increasingly use fiscal, social, and medical resources. Healthcare costs for Americans older than age 65 years are three to five times higher than for the remaining population, and dementia is the third most costly disease in the United States. Interventions that promote successful aging can help patients and reduce the financial, workforce, and treatment resource burdens on the population. Because a relationship between physical activity, particularly aerobic exercise, and cognitive decline has been established, physical activity interventions may prove practical, affordable, and effective. Attention to empiric research and knowledge of evidence-based strategies for prescribing physical activity are critical for PAs to embrace.

Mapping adipose and muscle tissue expression quantitative trait loci in African Americans to identify genes for type 2 diabetes and obesity.

Relative to European Americans, type 2 diabetes (T2D) is more prevalent in African Americans (AAs). Genetic variation may modulate transcript abundance in insulin-responsive tissues and contribute to risk; yet, published studies identifying expression quantitative trait loci (eQTLs) in African ancestry populations are restricted to blood cells. This study aims to develop a map of genetically regulated transcripts expressed in tissues important for glucose homeostasis in AAs, critical for identifying the genetic etiology of T2D and related traits. Quantitative measures of adipose and muscle gene expression, and genotypic data were integrated in 260 non-diabetic AAs to identify expression regulatory variants. Their roles in genetic susceptibility to T2D, and related metabolic phenotypes, were evaluated by mining GWAS datasets. eQTL analysis identified 1971 and 2078 cis-eGenes in adipose and muscle, respectively. Cis-eQTLs for 885 transcripts including top cis-eGenes CHURC1, USMG5, and ERAP2 were identified in both tissues. 62.1 % of top cis-eSNPs were within ±50 kb of transcription start sites and cis-eGenes were enriched for mitochondrial transcripts. Mining GWAS databases revealed association of cis-eSNPs for more than 50 genes with T2D (e.g. PIK3C2A, RBMS1, UFSP1), gluco-metabolic phenotypes (e.g. INPP5E, SNX17, ERAP2, FN3KRP), and obesity (e.g. POMC, CPEB4). Integration of GWAS meta-analysis data from AA cohorts revealed the most significant association for cis-eSNPs of ATP5SL and MCCC1 genes, with T2D and BMI, respectively. This study developed the first comprehensive map of adipose and muscle tissue eQTLs in AAs (publically accessible at https://mdsetaa.phs.wakehealth.edu ) and identified genetically regulated transcripts for delineating genetic causes of T2D, and related metabolic phenotypes.

RIG-I is required for VSV-induced cytokine production by murine glia and acts in combination with DAI to initiate responses to HSV-1.

A defining feature of viral central nervous system (CNS) infection is the rapid onset of severe neuroinflammation. However, the mechanisms underlying glial responses to replicative neurotropic viruses are only now becoming apparent with the discovery of a number of cytosolic sensors for viral nucleic acids. We have described the expression by murine and human glial cells of two disparate pattern recognition receptors, retinoic acid inducible gene-I (RIG-I) and DNA-dependent activator of interferon regulatory factors (DAI), receptors for viral RNA and DNA moieties, respectively. In the present study, we demonstrate the functional significance of RIG-I expression in primary murine microglia and astrocytes. Our data indicate that murine glial immune responses to a model neurotropic RNA virus, vesicular stomatitis virus, are RIG-I dependent and independent of levels of DAI expression or RNA polymerase III activity. In contrast, maximal glial inflammatory and antiviral responses to the DNA virus herpes simplex virus-1 (HSV-1) are dependent on the expression of both RIG-I and DAI, and require RNA polymerase III activity. These findings indicate that the RNA sensor, RIG-I, acts in parallel with DAI in an RNA polymerase III-dependent manner to initiate glial responses to HSV-1. We therefore suggest that RIG-I plays a significant role in the detection of both RNA and DNA pathogens by microglia and astrocytes.

Feasibility of Remote Administration of the Uniform Data Set-Version 3 for Assessment of Older Adults With Mild Cognitive Impairment and Alzheimer's Disease.

OBJECTIVE: Assess the feasibility and concurrent validity of a modified Uniform Data Set version 3 (UDSv3) for remote administration for individuals with normal cognition (NC), mild cognitive impairment (MCI), and early dementia. METHOD: Participants (N = 93) (age: 72.8 [8.9] years; education: 15.6 [2.5] years; 72% female; 84% White) were enrolled from the Wake Forest ADRC. Portions of the UDSv3 cognitive battery, plus the Rey Auditory Verbal Learning Test, were completed by telephone or video within ~6 months of participant's in-person visit. Adaptations for phone administration (e.g., Oral Trails for Trail Making Test [TMT] and Blind Montreal Cognitive Assessment [MoCA] for MoCA) were made. Participants reported on the pleasantness, difficulty, and preference for each modality. Staff provided validity ratings for assessments. Participants' remote data were adjudicated by cognitive experts blinded to the in person-diagnosis (NC [N = 44], MCI [N = 35], Dementia [N = 11], or other [N = 3]). RESULTS: Remote assessments were rated as pleasant as in-person assessments by 74% of participants and equally difficult by 75%. Staff validity rating (video = 92%; phone = 87.5%) was good. Concordance between remote/in-person scores was generally moderate to good (r = .3 -.8; p < .05) except for TMT-A/OTMT-A (r = .3; p > .05). Agreement between remote/in-person adjudicated cognitive status was good (k = .61-.64). CONCLUSIONS: We found preliminary evidence that older adults, including those with cognitive impairment, can be assessed remotely using a modified UDSv3 research battery. Adjudication of cognitive status that relies on remotely collected data is comparable to classifications using in-person assessments.

The CoREST repressor complex mediates phenotype switching and therapy resistance in melanoma.

Virtually all patients with BRAF-mutant melanoma develop resistance to MAPK inhibitors largely through nonmutational events. Although the epigenetic landscape is shown to be altered in therapy-resistant melanomas and other cancers, a specific targetable epigenetic mechanism has not been validated. Here, we evaluated the corepressor for element 1-silencing transcription factor (CoREST) epigenetic repressor complex and the recently developed bivalent inhibitor corin within the context of melanoma phenotype plasticity and therapeutic resistance. We found that CoREST was a critical mediator of the major distinct melanoma phenotypes and that corin treatment of melanoma cells led to phenotype reprogramming. Global assessment of transcript and chromatin changes conferred by corin revealed specific effects on histone marks connected to epithelial-mesenchymal transition-associated (EMT-associated) transcription factors and the dual-specificity phosphatases (DUSPs). Remarkably, treatment of BRAF inhibitor-resistant (BRAFi-R) melanomas with corin promoted resensitization to BRAFi therapy. DUSP1 was consistently downregulated in BRAFi-R melanomas, which was reversed by corin treatment and associated with inhibition of p38 MAPK activity and resensitization to BRAFi therapies. Moreover, this activity was recapitulated by the p38 MAPK inhibitor BIRB 796. These findings identify the CoREST repressor complex as a central mediator of melanoma phenotype plasticity and resistance to targeted therapy and suggest that CoREST inhibitors may prove beneficial for patients with BRAFi-resistant melanoma.

Parenteral Nutrition in the Neonatal Intensive Care Unit: Intravenous Lipid Emulsions.

Intravenous lipid emulsions (ILEs) are a source of nonprotein calories and fatty acids and help promote growth in preterm infants and infants with intestinal failure. An ILE dose and oil source determines its fatty acid, phytosterol, and vitamin E delivery. These factors play a role in the infant's risk for essential fatty acid deficiency and cholestasis, and help modulate inflammation, immunity, and organ development. This article reviews different ILEs and their constituents and their relationship with neonatal health.

Impact of Undergoing Thoracolumbar Surgery on Patient Psychosocial Profiles.

STUDY DESIGN: Prospective cohort study. OBJECTIVE: Investigate the impact of thoracolumbar surgery on patients' psychosocial profiles. METHODS: A prospective cohort study of thoracolumbar surgery patients (N = 177). Measures of interest collected at baseline and 24-months after surgery were: modified Oswestry Disability Index (mODI), Numerical Rating Scores for Back Pain (NRS-B), Leg Pain (NRS-L), Pain Catastrophizing Scale (PCS), Tampa Scale of Kinesiophobia (TSK), Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), Multidimensional Scale of Perceived Social Support (MSPSS), Mental Component Summary (MCS) and patient expectations for surgery impacts on mental well-being. Cohorts were separated based on attaining meaningful change defined as either 30% improvement or minimal scores in NRS-B, NRS-L and mODI. Mixed measures ANOVAs were run (α = .05). RESULTS: Patients who showed meaningful change had significant improvements in PCS, TSK and CPAQ-8 scores but not in MSPSS scores. Patients had improvement in MCS scores over 24-months follow-up, but this change was not significantly different based on attainment of meaningful change. Overall, 75.9% of patients reported their mental well-being expectations were met. Patients who did not achieve meaningful change showed no change on any psychosocial measures with only 55.9% reporting their mental well-being expectations met. CONCLUSION: Thoracolumbar surgery results in significant improvement of psychosocial variables for patients who experienced meaningful change for pain and disability. Worsening of psychosocial health was not evident in patients who did not attain meaningful change.

Are Physician Assistants Able to Correctly Identify Prescribing Errors? A Cross-Sectional Study.

PURPOSE: (1) To describe how often physician assistant (PA) students correctly identify prescribing errors and (2) examine between-cohort differences on ability to correctly identify prescribing errors. METHODS: This was a cross-sectional study of 2 cohorts of PA students at one institution. Students were presented with 3 hypothetical prescriptions, 2 of which contained a prescribing error. For each prescription, students were asked to (1) identify whether an error occurred and (2) indicate the type of error. A simple Poisson regression model analyzed the data. RESULTS: We received responses from 130 students (72.6% response rate). Approximately 12% (12.3%, n = 16) correctly identified whether all 3 prescriptions were correct. The median number of correctly identified prescriptions was 1 (interquartile range = 1). There was not a statistically significant between-cohort difference identifying the correct number of prescriptions (ß = 0.27, P = .10). CONCLUSION: Physician assistant students' prescribing error identification was similar to previous research in medical and nursing students. Efforts to improve prescribing training are critical to ensure patient safety.

Adaptation and factor structure of three psychometric instruments measuring behavioral aspects of medication prescribing in physician assistants.

OBJECTIVES: (1) Present the factor structure of two psychometric instruments for self-efficacy and one for outcome expectations of medication prescribing; (2) evaluate the reliability of the scales, and (3) present preliminary evidence of validity. METHODS: Physician assistants (PA) and PA students completed a survey evaluating three psychometric instruments: (1) Self-Efficacy in Prescribing (SEP), (2) Self-Efficacy in Prescribing-Geriatric (SEPG), and (3) Outcomes Expectations of Prescribing Errors (OEP). Students also evaluated 3 hypothetical prescriptions, two of which contained a prescribing error. Students were instructed to identify (1) if an error occurred and (2) what type of error. The data were analyzed using parallel analysis with a varimax rotation, Cronbach's α, Pearson and Spearman correlations. RESULTS: One hundred eighty five (n = 185) respondents completed the survey (response rate = 63.8%). The parallel analysis found that the SEP had one 7-item factor with α = 0.94 (M = 5.7 (SD = 1.9) out of 10). The SEPG also had one 7-item factor with α = 0.95 (M = 5.5 (1.9). The OEP had one 6-item factor with α = 0.89 (M = 3.5 (SD = 0.8) out of 5). The SEP and SEPG, were correlated to the OEP each other (both p < 0.01). Actively practicing PAs had the highest composite mean SEP and SEPG scores. First-year PA students had the highest mean scores for the OEP. There was a weak association between the mean SEPG score and the number of correctly identified prescriptions (rs = 0.18, p = 0.04). CONCLUSION: The SEP, SEPG, and OEP show preliminary evidence of reliability and structural, construct, and known-group validities using simulated prescriptions. These tools may be able to be used by educators and implementation scientists as one method to show the effectiveness of future interventions to reduce incidence of prescribing errors.

Mothers' accounts of mealtime and feeding challenges for children with Tourette syndrome or persistent tic disorders.

Parenting a young person with a tic disorder can present daily challenges to families struggling to manage their child's tics and establish routines. Research recognises that tics can be problematic to everyday activities, however no attention has been given to mealtimes, arguably an important family activity closely related to quality of life of the family. The current qualitative study aimed to investigate the mealtime experiences of families with a child with a tic disorder from the perspective of mothers, looking at mealtime challenges, their impact and how these challenges are navigated. Seventeen mothers with children diagnosed with Tourette Syndrome (TS) or a Persistent Tic Disorder (PTD) (aged 3-14) took part in semi-structured interviews. Interpretative phenomenological analysis of 17 semi-structured interviews resulted in seven subthemes which were grouped under two superordinate themes: (1) tics as a barrier to positive mealtime experiences and (2) eating behaviours and other mealtime challenges. The findings highlight tics to create functional mealtime challenges, affecting a young person's ability to eat, drink and be seated, with mothers noting the family dynamic was often intensified and compounded by additional challenges related to their child's tics and comorbidities. Tics also have the power to disrupt the conviviality of mealtimes. For example, eating out-of-home can be especially challenging, with restaurants being high-pressure environments for young people with tics and their families. The cumulative effect of dissatisfaction, stress and additional foodwork can have a diminishing effect on maternal and familial resilience and wellbeing. Mealtime-related interventions need to be considered to help increase confidence and skills in managing mealtimes.

Drugging the Epigenome: Overcoming Resistance to Targeted and Immunotherapies in Melanoma.

This past decade has seen tremendous advances in understanding the molecular pathogenesis of melanoma and the development of novel effective therapies for melanoma. Targeted therapies and immunotherapies that extend survival of patients with advanced disease have been developed; however, the vast majority of patients experience relapse and therapeutic resistance over time. Moreover, cellular plasticity has been demonstrated to be a driver of therapeutic resistance mechanisms in melanoma and other cancers, largely functioning through epigenetic mechanisms, suggesting that targeting of the cancer epigenetic landscape may prove a worthwhile endeavor to ensure durable treatment responses and cures. Here, we review the epigenetic alterations that characterize melanoma development, progression, and resistance to targeted therapies as well as epigenetic therapies currently in use and under development for melanoma and other cancers. We further assess the landscape of epigenetic therapies in clinical trials for melanoma and provide a framework for future advances in epigenetic therapies to circumvent the development of therapeutic resistance in melanoma.

Changes to household food shopping practices during the COVID-19 restrictions: Evidence from the East of England.

Measures to control the spread of COVID-19 have changed the way we shop for food and interact with food environments. This qualitative study explored food shopping practices in the East of England, a large diverse region including coastal, urban and rural settings. In 2020/2021 we interviewed 38 people living in the region and 27 professionals and volunteers providing local support around dietary health. Participants reported disruption to supermarket shopping routines; moving to online shopping; and increased reliance on local stores. COVID-19 has impacted disproportionately upon lower-income households and neighbourhoods. The longer-term implications for dietary health inequalities must be investigated.

Vascular and microstructural markers of cognitive pathology.

Introduction: Arterial stiffness may play a role in the development of dementia through poorly understood effects on brain microstructural integrity and perfusion. Methods: We examined markers of arterial stiffness (carotid-femoral pulse wave velocity [cfPWV]) and elevated systolic blood pressure (SBP) in relation to cognitive function and brain magnetic resonance imaging macrostructure (gray matter [GM] and white matter [WM] volumes), microstructure (diffusion based free water [FW] and fractional anisotropy [FA]), and cerebral blood flow (CBF) in WM and GM in models adjusted for age, race, sex, education, and apolipoprotein E ε4 status. Results: Among 460 participants (70 ± 8 years; 44 dementia, 158 mild cognitive impairment, 258 normal cognition), higher cfPWV and SBP were independently associated with higher FW, higher WM hyperintensity volume, and worse cognition (global and executive function). Higher SBP alone was significantly associated with lower WM and GM CBF. Discussion: Arterial stiffness is associated with impaired WM microstructure and global and executive cognitive function.