Elevated pulse pressure modifies theory of mind performance in older adults

Objectives: Age reductions in theory of mind (ToM) are well documented, though underlying mechanisms are poorly understood. Research suggests that traditional cognitive abilities underlie ToM in part; however, whether age-associated health modifiers also predict ToM remains unknown. We investigated the role of pulse pressure (PP), an age-related marker of vascular risk, in modifying ToM performance. Method: Sixty-six community-dwelling older adults (65'92 years) completed a short story paradigm assessing ToM. Participants also completed measures assessing blood pressure and cognitive abilities empirically linked to ToM. We used hierarchical regression to test our prediction that high PP would adversely influence associations between ToM and cognition. Results: Reduced ToM was associated with older age and decreased verbal memory, processing speed, and working memory; however, associations between ToM and working memory were attenuated when PP was included in the regression model. Importantly, associations between ToM, memory, and processing speed were qualified by vascular health, in that participants with elevated PP showed stronger associations between reduced ToM and lower memory/speed. Discussion: This is the first study to demonstrate that vascular risk modifies the strength of associations between ToM and age-sensitive cognitive resources. Results add to current perspectives on mechanisms influencing reduced ToM in older age.