Kapasi Alifiya, Capuano Ana W, Lamar Melissa, Leurgans Sue E, Evia Arnold M, Bennett David A, Arfanakis Konstantinos, Schneider Julie A
Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL.
Department of Pathology (Neuropathology) Rush University Medical Center Chicago IL.
J Am Heart Assoc. 2024 Feb 6;13(3):e031551. doi: 10.1161/JAHA.123.031551. Epub 2024 Jan 19.
Lower hippocampal volume is associated with late-life cognitive decline and is an important, but nonspecific marker for clinical Alzheimer's dementia. Cerebrovascular disease may also be associated with hippocampal volume. Here we study the role of intracranial large vessel disease (atherosclerosis) in association with hippocampal volume and the potential role of age, average late-life blood pressure across all visits, and other factors (sex, apolipoprotein ε4 [ ε4], and diabetes).
Data came from 765 community-based older people (91 years old on average at death; 72% women), from 2 ongoing clinical-pathologic cohort studies. Participants completed baseline assessment, annual standardized blood pressure measurements, vascular risk assessment for diabetes, and blood draws to determine genotype, and at death, brains were removed and underwent ex vivo magnetic resonance imaging and neuropathologic evaluation for atherosclerosis pathology and other cerebrovascular and neurodegenerative pathologies. Linear regression models examined the association of atherosclerosis and hippocampal to hemisphere volume ratio and whether age at death, blood pressure, and other factors modified associations. In linear regression models adjusted for demographics and neurodegenerative and other cerebrovascular pathologies, atherosclerosis severity was associated with a lower hippocampal to hemisphere volume ratio. In separate models, we found the effect of atherosclerosis on the ratio of hippocampal to hemisphere volume was attenuated among advanced age at death or having higher systolic blood pressure (interaction terms ≤0.03). We did not find confounding or interactions with sex, diabetes, or ε4.
Atherosclerosis severity is associated with lower hippocampal volume, independent of neurodegenerative and other cerebrovascular pathologies. Higher systolic blood pressures and advanced age attenuate associations.
海马体体积减小与晚年认知能力下降有关，是临床阿尔茨海默病痴呆的一个重要但非特异性标志物。脑血管疾病也可能与海马体体积有关。在此，我们研究颅内大血管疾病（动脉粥样硬化）与海马体体积的关系，以及年龄、所有就诊时的平均晚年血压和其他因素（性别、载脂蛋白ε4 [ε4]和糖尿病）的潜在作用。
数据来自两项正在进行的临床病理队列研究中的765名社区老年人（平均死亡年龄91岁；72%为女性）。参与者完成了基线评估、年度标准化血压测量、糖尿病血管风险评估以及血样采集以确定基因型，在死亡时，取出大脑并进行离体磁共振成像以及动脉粥样硬化病理和其他脑血管及神经退行性病变的神经病理学评估。线性回归模型研究了动脉粥样硬化与海马体与半球体积比的关联，以及死亡年龄、血压和其他因素是否会改变这种关联。在针对人口统计学、神经退行性和其他脑血管病变进行调整的线性回归模型中，动脉粥样硬化严重程度与较低的海马体与半球体积比相关。在单独的模型中，我们发现动脉粥样硬化对海马体与半球体积比的影响在死亡时年龄较大或收缩压较高的人群中减弱（交互项≤0.03）。我们未发现性别、糖尿病或ε4存在混杂或交互作用。
动脉粥样硬化严重程度与较低的海马体体积相关，独立于神经退行性和其他脑血管病变。较高的收缩压和高龄会减弱这种关联。
