1. In Vivo Brain Plaque and Tangle Burden Mediates the Association Between Diastolic Blood Pressure and Cognitive Functioning in Nondemented Adults
- Author
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Natacha D. Emerson, Linda M. Ercoli, David A. Merrill, Jorge R. Barrio, Florence F. Roussotte, Gary W. Small, Prabha Siddarth, Katherine L. Narr, and J.L. Martinez
- Subjects
Male ,Gerontology ,Aging ,Plaque, Amyloid ,Blood Pressure ,Neurodegenerative ,030204 cardiovascular system & hematology ,Cardiovascular ,Alzheimer's Disease ,0302 clinical medicine ,80 and over ,Cognitive decline ,age-related cognitive decline ,Plaque ,Aged, 80 and over ,medicine.diagnostic_test ,Neurofibrillary Tangles ,Cognition ,Neuropsychological test ,Middle Aged ,plaques ,Psychiatry and Mental health ,Hypertension ,Neurological ,Public Health and Health Services ,Cardiology ,Biomedical Imaging ,Female ,Cognitive Sciences ,Psychology ,Adult ,Amyloid ,medicine.medical_specialty ,Mediation (statistics) ,Clinical Sciences ,Neuropathology ,Article ,03 medical and health sciences ,Internal medicine ,Nitriles ,Acquired Cognitive Impairment ,medicine ,Humans ,Cognitive Dysfunction ,Cognitive skill ,Effects of sleep deprivation on cognitive performance ,Aged ,tangles ,Prevention ,diastolic blood pressure ,Neurosciences ,Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) ,FDDNP-PET ,Brain Disorders ,Blood pressure ,Geriatrics ,Positron-Emission Tomography ,Dementia ,Geriatrics and Gerontology ,030217 neurology & neurosurgery - Abstract
Objective Growing evidence supports an association between increased blood pressure and: (a) poor cognitive performance in older adults, and (b) various biomarkers of increased Alzheimer's disease (AD) neuropathology. The objective of this study was to determine whether systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly associated with cognitive functioning in non-demented adults, and to examine in vivo AD pathology as a possible mediator of this association. Methods Positron emission tomography (PET) scans with 2-(1-{6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene)malononitrile (FDDNP) provide in vivo measurements of plaque and tangle burden. A total of 101 non-demented older subjects with blood pressure data and FDDNP-PET scans were drawn from a larger study of predictors of cognitive decline. A neuropsychological test battery was used to compute "global cognitive scores" (averaged across five key domains), which served as an index of general cognitive functioning. Results Higher DBP (but not SBP) was significantly associated with lower cognitive scores, controlling for age, sex, antihypertensive medication use, and ApoE genotype (η 2 = 0.06). However, this relationship was no longer significant after introducing FDDNP-PET binding as an additional covariate in the statistical models. In vivo plaque and tangle burden accounted for over 30% of the observed association between higher DBP and poorer cognitive performance. Conclusions By suggesting a mediation of the relationship between DBP and cognitive functioning by FDDNP-PET binding, this study advances our understanding of some potential predictors of cognitive decline in non-demented adults, and underscores the importance of devising early multimodal interventions to more effectively combat degenerative brain disorders.
- Published
- 2018
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