Nation Daniel A, Preis Sarah R, Beiser Alexa, Bangen Katherine J, Delano-Wood Lisa, Lamar Melissa, Libon David J, Seshadri Sudha, Wolf Philip A, Au Rhoda
*Department of Psychology, University of Southern California, Los Angeles∥Veterans Affairs San Diego Healthcare System¶Department of Psychiatry, University of California, San Diego, La Jolla, CA†The Framingham Heart Study, FraminghamDepartments of ‡Biostatistics§Department of Neurology, Boston University School of Medicine, Boston, MA#Department of Psychiatry, University of Illinois at Chicago, Chicago, IL**Drexel Neuroscience Institute, College of Medicine, Drexel University, Philadelphia, PA.
Alzheimer Dis Assoc Disord. 2016 Jul-Sep;30(3):210-5. doi: 10.1097/WAD.0000000000000127.
We investigated whether midlife pulse pressure is associated with brain atrophy and cognitive decline, and whether the association was modified by apolipoprotein-E ε4 (APOE-ε4) and hypertension. Participants (549 stroke-free and dementia-free Framingham Offspring Cohort Study participants, age range=55.0 to 64.9 y) underwent baseline neuropsychological and magnetic resonance imaging (subset, n=454) evaluations with 5- to 7-year follow-up. Regression analyses investigated associations between baseline pulse pressure (systolic-diastolic pressure) and cognition, total cerebral volume and temporal horn ventricular volume (as an index of smaller hippocampal volume) at follow-up, and longitudinal change in these measures. Interactions with APOE-ε4 and hypertension were assessed. Covariates included age, sex, education, assessment interval, and interim stroke. In the total sample, baseline pulse pressure was associated with worse executive ability, lower total cerebral volume, and greater temporal horn ventricular volume 5 to 7 years later, and longitudinal decline in executive ability and increase in temporal horn ventricular volume. Among APOE-ε4 carriers only, baseline pulse pressure was associated with longitudinal decline in visuospatial organization. Findings indicate arterial stiffening, indexed by pulse pressure, may play a role in early cognitive decline and brain atrophy in mid to late life, particularly among APOE-ε4 carriers.
我们研究了中年脉压是否与脑萎缩和认知衰退相关，以及这种关联是否会因载脂蛋白Eε4（APOE-ε4）和高血压而改变。参与者（549名无中风且无痴呆的弗雷明汉心脏研究后代队列研究参与者，年龄范围=55.0至64.9岁）接受了基线神经心理学和磁共振成像（子样本，n = 454）评估，并进行了5至7年的随访。回归分析研究了基线脉压（收缩压 - 舒张压）与随访时的认知、全脑体积和颞角脑室体积（作为较小海马体积的指标）之间的关联，以及这些指标的纵向变化。评估了与APOE-ε4和高血压的相互作用。协变量包括年龄、性别、教育程度、评估间隔和期间中风情况。在总样本中，基线脉压与5至7年后较差的执行能力、较低的全脑体积和较大的颞角脑室体积相关，以及执行能力的纵向下降和颞角脑室体积的增加。仅在APOE-ε4携带者中，基线脉压与视觉空间组织的纵向下降相关。研究结果表明，以脉压为指标的动脉僵硬可能在中年后期的早期认知衰退和脑萎缩中起作用，特别是在APOE-ε4携带者中。
