Associations among hypertension, dementia biomarkers, and cognition: The MEMENTO cohort.
amyloid beta 42
cognition
cortical thickness
fluorodeoxyglucose positron emission tomography
hippocampal volume
hypertension
mediation
positron emission tomography amyloid
structural equation model
tau
white matter hyperintensities
Journal
Alzheimer's & dementia : the journal of the Alzheimer's Association
ISSN: 1552-5279
Titre abrégé: Alzheimers Dement
Pays: United States
ID NLM: 101231978
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
revised:
12
09
2022
received:
20
05
2022
accepted:
05
10
2022
medline:
13
6
2023
pubmed:
6
12
2022
entrez:
5
12
2022
Statut:
ppublish
Résumé
Approximately 40% of dementia cases could be delayed or prevented acting on modifiable risk factors including hypertension. However, the mechanisms underlying the hypertension-dementia association are still poorly understood. We conducted a cross-sectional analysis in 2048 patients from the MEMENTO cohort, a French multicenter clinic-based study of outpatients with either isolated cognitive complaints or mild cognitive impairment. Exposure to hypertension was defined as a combination of high blood pressure (BP) status and antihypertensive treatment intake. Pathway associations were examined through structural equation modeling integrating extensive collection of neuroimaging biomarkers and clinical data. Participants treated with high BP had significantly lower cognition compared to the others. This association was mediated by higher neurodegeneration and higher white matter hyperintensities load but not by Alzheimer's disease (AD) biomarkers. These results highlight the importance of controlling hypertension for prevention of cognitive decline and offer new insights on mechanisms underlying the hypertension-dementia association. Paths of hypertension-cognition association were assessed by structural equation models. The hypertension-cognition association is not mediated by Alzheimer's disease biomarkers. The hypertension-cognition association is mediated by neurodegeneration and leukoaraiosis. Lower cognition was limited to participants treated with uncontrolled blood pressure. Blood pressure control could contribute to promote healthier brain aging.
Substances chimiques
Biomarkers
0
Amyloid beta-Peptides
0
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2332-2342Informations de copyright
© 2022 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
Références
Collaborators GBDDF. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Heal. 2022;396(10248):413-446. https://doi.org/10.1016/S2468-2667(21)00249-8
Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020; 396(10248): 413-446. https://doi.org/10.1016/S0140-6736(20)30367-6
Yu JT, Xu W, Tan CC, et al. Evidence-based prevention of Alzheimer's disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry. 2020; 91(11): 1201-1209. https://doi.org/10.1136/jnnp-2019-321913
Takeda S, Rakugi H, Morishita R. Roles of vascular risk factors in the pathogenesis of dementia. Hypertens Res. 2020; 43(3): 162-167. https://doi.org/10.1038/s41440-019-0357-9
Iturria-Medina Y, Sotero RC, Toussaint PJ, Mateos-Perez JM, Evans AC. Alzheimer's Disease Neuroimaging I. Early role of vascular dysregulation on late-onset Alzheimer's disease based on multifactorial data-driven analysis. Nat Commun. 2016; 7: 11934. https://doi.org/10.1038/ncomms11934
Emdin CA, Rothwell PM, Salimi-Khorshidi G, et al. Blood Pressure and risk of vascular dementia: evidence from a primary care registry and a cohort study of transient ischemic attack and stroke. Stroke. 2016; 47(6): 1429-1435. https://doi.org/10.1161/STROKEAHA.116.012658
Burke GL, Hughes TM. Arterial changes connecting hypertension to Alzheimer's disease and related dementias. JACC Cardiovasc Imaging. 2021; 14(1): 186-188. https://doi.org/10.1016/j.jcmg.2020.10.018
Collaborators GBDS. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):439-458. https://doi.org/10.1016/S1474-4422(19)30034-1
Launer LJ, Hughes T, Yu B, et al. Lowering midlife levels of systolic blood pressure as a public health strategy to reduce late-life dementia: perspective from the Honolulu Heart Program/Honolulu Asia Aging Study. Hypertension. 2010; 55(6): 1352-1359. https://doi.org/10.1161/HYPERTENSIONAHA.109.147389
Launer LJ, Ross GW, Petrovitch H, et al. Midlife blood pressure and dementia: the Honolulu-Asia aging study. Neurobiol Aging. 2000; 21(1): 49-55. https://doi.org/10.1016/s0197-4580(00)00096-8
Whitmer RA, Sidney S, Selby J, Johnston SC, Yaffe K. Midlife cardiovascular risk factors and risk of dementia in late life. Neurology. 2005; 64(2): 277-281. https://doi.org/10.1212/01.WNL.0000149519.47454.F2
Meng XF, Yu JT, Wang HF, et al. Midlife vascular risk factors and the risk of Alzheimer's disease: a systematic review and meta-analysis. J Alzheimers Dis. 2014; 42(4): 1295-1310. https://doi.org/10.3233/JAD-140954
Power MC, Weuve J, Gagne JJ, McQueen MB, Viswanathan A, Blacker D. The association between blood pressure and incident Alzheimer disease: a systematic review and meta-analysis. Epidemiology. 2011; 22(5): 646-659. https://doi.org/10.1097/EDE.0b013e31822708b5
Proitsi P. Disentangling the complex relationship between hypertension and dementia. Biol Psychiatry. 2021; 89(8): 742-744. https://doi.org/10.1016/j.biopsych.2021.02.005
de Leeuw FE, de Groot JC, Oudkerk M, et al. Hypertension and cerebral white matter lesions in a prospective cohort study. Brain. 2002; 125: 765-772. https://doi.org/10.1093/brain/awf077
Dufouil C, Chalmers J, Coskun O, et al. Effects of blood pressure lowering on cerebral white matter hyperintensities in patients with stroke: the PROGRESS (Perindopril Protection Against Recurrent Stroke Study) Magnetic Resonance Imaging Substudy. Circulation. 2005; 112(11): 1644-1650. https://doi.org/10.1161/CIRCULATIONAHA.104.501163
Godin O, Tzourio C, Maillard P, Mazoyer B, Dufouil C. Antihypertensive treatment and change in blood pressure are associated with the progression of white matter lesion volumes: the Three-City (3C)-Dijon Magnetic Resonance Imaging Study. Circulation. 2011; 123(3): 266-273. https://doi.org/10.1161/CIRCULATIONAHA.110.961052
Jochemsen HM, Muller M, Visseren FL, et al. Blood pressure and progression of brain atrophy: the SMART-MR Study. JAMA Neurol. 2013; 70(8): 1046-1053. https://doi.org/10.1001/jamaneurol.2013.217
Jeon SY, Byun MS, Yi D, et al. Influence of hypertension on brain amyloid deposition and Alzheimer's disease signature neurodegeneration. Neurobiol Aging. 2019; 75: 62-70. https://doi.org/10.1016/j.neurobiolaging.2018.11.001
Godin O, Maillard P, Crivello F, et al. Association of white-matter lesions with brain atrophy markers: the three-city Dijon MRI study. Cerebrovasc Dis. 2009; 28(2): 177-184. https://doi.org/10.1159/000226117
Dufouil C, Dubois B, Vellas B, et al. Cognitive and imaging markers in non-demented subjects attending a memory clinic: study design and baseline findings of the MEMENTO cohort. Alzheimers Res Ther. 2017; 9(1): 67. https://doi.org/10.1186/s13195-017-0288-0
Grober E, Buschke H, Crystal H, Bang S, Dresner R. Screening for dementia by memory testing. Neurology. 1988; 38(6): 900-903. https://doi.org/10.1212/wnl.38.6.900
Tombaugh TN. Trail Making Test A and B: normative data stratified by age and education. Arch Clin Neuropsychol. 2004; 19(2): 203-214. https://doi.org/10.1016/S0887-6177(03)00039-8
Operto G, Chupin M, Batrancourt B, et al. CATI: a large distributed infrastructure for the neuroimaging of cohorts. Neuroinformatics. 2016; 14(3): 253-264. https://doi.org/10.1007/s12021-016-9295-8
Ashburner J, Friston KJ. Unified segmentation. Neuroimage. 2005; 26(3): 839-851. https://doi.org/10.1016/j.neuroimage.2005.02.018
Chupin M, Hammers A, Liu RS, et al. Automatic segmentation of the hippocampus and the amygdala driven by hybrid constraints: method and validation. Neuroimage. 2009; 46(3): 749-761. https://doi.org/10.1016/j.neuroimage.2009.02.013
Desikan RS, Segonne F, Fischl B, et al. An automated labeling system for subdividing the human cerebral cortex on MRI scans into gyral based regions of interest. Neuroimage. 2006; 31(3): 968-980. https://doi.org/10.1016/j.neuroimage.2006.01.021
Samaille T, Fillon L, Cuingnet R, et al. Contrast-based fully automatic segmentation of white matter hyperintensities: method and validation. PLoS One. 2012; 7(11): e48953. https://doi.org/10.1371/journal.pone.0048953
Habert MO, Marie S, Bertin H, et al. Optimization of brain PET imaging for a multicentre trial: the French CATI experience. EJNMMI Phys. 2016; 3(1). https://doi.org/10.1186/s40658-016-0141-8
Buchert R, Wilke F, Chakrabarti B, et al. Adjusted scaling of FDG positron emission tomography images for statistical evaluation in patients with suspected Alzheimer's disease. J Neuroimaging. 2005; 15(4): 348-355. https://doi.org/10.1177/1051228405280169
Toussaint PJ, Perlbarg V, Bellec P, et al. Resting state FDG-PET functional connectivity as an early biomarker of Alzheimer's disease using conjoint univariate and independent component analyses. Neuroimage. 2012; 63(2): 936-946. https://doi.org/10.1016/j.neuroimage.2012.03.091
Little RJ, Rubin DB, Statistical Analysis with Missing Data. 2nd ed. Hoboken (N.J.): Wiley-Interscience; 2002.
Brosseau-Liard PE, Savalei V. Adjusting incremental fit indices for nonnormality. Multivariate Behav Res. 2014; 49(5): 460-470. https://doi.org/10.1080/00273171.2014.933697
Rosseel Y. lavaan: an R package for structural equation modeling. J Stat Softw. 2012; 48: 1-36. https://doi.org/10.18637/jss.v048.i02 2 SE-Articles
Dufouil C, de Kersaint-Gilly A, Besancon V, et al. Longitudinal study of blood pressure and white matter hyperintensities: the EVA MRI Cohort. Neurology. 2001; 56(7): 921-926. https://doi.org/10.1212/wnl.56.7.921
Law CSW, Yeong KY. Repurposing antihypertensive drugs for the management of Alzheimer's disease. Curr Med Chem. 2021; 28(9): 1716-1730. https://doi.org/10.2174/0929867327666200312114223
den Brok M, van Dalen JW, Abdulrahman H, et al. Antihypertensive medication classes and the risk of dementia: a systematic review and network meta-analysis. J Am Med Dir Assoc. 2021; 22(7): 1386-1395. https://doi.org/10.1016/j.jamda.2020.12.019. e15.
Cunningham EL, Todd SA, Passmore P, Bullock R, McGuinness B. Pharmacological treatment of hypertension in people without prior cerebrovascular disease for the prevention of cognitive impairment and dementia. Cochrane Database Syst Rev. 2021; 5: CD004034. https://doi.org/10.1002/14651858.CD004034.pub4
Wang Q, He C, Zhu Y, Zhang Q, Zhang Z, Xie C. Cortical atrophy mediates the accumulating effects of vascular risk factors on cognitive decline in the Alzheimer's disease spectrum. Aging (Albany NY). 2020; 12(14): 15058-15076. 10.18632/aging.103573
Garcia-Alberca JM, Mendoza S, Gris E, Royo JL, Cruz-Gamero JM, Garcia-Casares N. White matter lesions and temporal atrophy are associated with cognitive and neuropsychiatric symptoms in patients with hypertension and Alzheimer's disease. Int J Geriatr Psychiatry. 2020; 35(11): 1292-1300. https://doi.org/10.1002/gps.5366
Manolio TA, Olson J, Longstreth WT. Hypertension and cognitive function: pathophysiologic effects of hypertension on the brain. Curr Hypertens Rep. 2003; 5(3): 255-261. https://doi.org/10.1007/s11906-003-0029-6
Haight T, Nick Bryan R, Erus G, et al. White matter microstructure, white matter lesions, and hypertension: an examination of early surrogate markers of vascular-related brain change in midlife. Neuroimage Clin. 2018; 18: 753-761. https://doi.org/10.1016/j.nicl.2018.02.032
Group SR, Wright Jr JT, Williamson JD, et al. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015; 373(22): 2103-2116. https://doi.org/10.1056/NEJMoa1511939
Group SMI for the SR. Williamson JD, Pajewski NM, Pajewski NM, et al, Group SMI for the SR. Effect of intensive vs standard blood pressure control on probable dementia: a randomized clinical trial. JAMA. 2019; 321(6): 553-561. https://doi.org/10.1001/jama.2018.21442
Group TSMI for the SR. Nasrallah IM, Pajewski NM, Auchus AP, et al, Group TSMI for the SR. Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions. JAMA. 2019; 322(6): 524-534. https://doi.org/10.1001/jama.2019.10551
Zlokovic BV. Neurovascular pathways to neurodegeneration in Alzheimer's disease and other disorders. Nat Rev Neurosci. 2011; 12(12): 723-738. https://doi.org/10.1038/nrn3114
Corlier F, Hafzalla G, Faskowitz J, et al. Systemic inflammation as a predictor of brain aging: contributions of physical activity, metabolic risk, and genetic risk. Neuroimage. 2018; 172: 118-129. https://doi.org/10.1016/j.neuroimage.2017.12.027
Heneka MT, Carson MJ, El Khoury J, et al. Neuroinflammation in Alzheimer's disease. Lancet Neurol. 2015; 14(4): 388-405. https://doi.org/10.1016/S1474-4422(15)70016-5