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老年人逐搏血压变异性、海马萎缩与记忆损害

Beat-to-beat blood pressure variability, hippocampal atrophy, and memory impairment in older adults.

作者信息

Lohman Trevor, Sible Isabel, Engstrom Allison C, Kapoor Arunima, Shenasa Fatemah, Head Elizabeth, Sordo Lorena, Alitin John Paul M, Gaubert Aimee, Nguyen Amy, Rodgers Kathleen E, Bradford David, Nation Daniel A

机构信息

Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.

Department of Psychology, University of Southern California, Los Angeles, CA, USA.

出版信息

Geroscience. 2025 Feb;47(1):993-1003. doi: 10.1007/s11357-024-01303-z. Epub 2024 Aug 5.

Abstract

Visit-to-visit blood pressure variability (BPV) predicts age-related hippocampal atrophy, neurodegeneration, and memory decline in older adults. Beat-to-beat BPV may represent a more reliable and efficient tool for prospective risk assessment, but it is unknown whether beat-to-beat BPV is similarly associated with hippocampal neurodegeneration, or with plasma markers of neuroaxonal/neuroglial injury. Independently living older adults without a history of dementia, stroke, or other major neurological disorders were recruited from the community (N = 104; age = 69.5 ± 6.7 (range 55-89); 63% female). Participants underwent continuous blood pressure monitoring, brain MRI, venipuncture, and cognitive testing over two visits. Hippocampal volumes, plasma neurofilament light, and glial fibrillary acidic protein levels were assessed. Beat-to-beat BPV was quantified as systolic blood pressure average real variability during 7-min of supine continuous blood pressure monitoring. The cross-sectional relationship between beat-to-beat BPV and hippocampal volumes, cognitive domain measures, and plasma biomarkers was assessed using multiple linear regression with adjustment for demographic covariates, vascular risk factors, and average systolic blood pressure. Elevated beat-to-beat BPV was associated with decreased left hippocampal volume (P = .008), increased plasma concentration of glial fibrillary acidic protein (P = .006), and decreased memory composite score (P = .02), independent of age, sex, average systolic blood pressure, total intracranial volume, and vascular risk factor burden. In summary, beat-to-beat BPV is independently associated with decreased left hippocampal volume, increased neuroglial injury, and worse memory ability. Findings are consistent with prior studies examining visit-to-visit BPV and suggest beat-to-beat BPV may be a useful marker of hemodynamic brain injury in older adults.

摘要

就诊间血压变异性(BPV)可预测老年人与年龄相关的海马萎缩、神经退行性变和记忆衰退。逐搏BPV可能是一种更可靠、更有效的前瞻性风险评估工具,但尚不清楚逐搏BPV是否与海马神经退行性变或神经轴突/神经胶质损伤的血浆标志物存在类似关联。从社区招募了无痴呆、中风或其他重大神经系统疾病病史的独立生活老年人(N = 104;年龄 = 69.5 ± 6.7(范围55 - 89岁);63%为女性)。参与者在两次就诊期间接受了连续血压监测、脑部MRI、静脉穿刺和认知测试。评估了海马体积、血浆神经丝轻链和胶质纤维酸性蛋白水平。逐搏BPV被量化为仰卧位连续血压监测7分钟期间收缩压的平均实际变异性。使用多元线性回归评估逐搏BPV与海马体积、认知领域指标和血浆生物标志物之间的横断面关系,并对人口统计学协变量、血管危险因素和平均收缩压进行了调整。独立于年龄、性别、平均收缩压、总颅内体积和血管危险因素负担,逐搏BPV升高与左侧海马体积减小(P = 0.008)、血浆胶质纤维酸性蛋白浓度升高(P = 0.006)和记忆综合评分降低(P = 0.02)相关。总之,逐搏BPV与左侧海马体积减小、神经胶质损伤增加和记忆能力较差独立相关。研究结果与之前关于就诊间BPV的研究一致,并表明逐搏BPV可能是老年人血流动力学脑损伤的一个有用标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61d8/11872826/21b09135fe83/11357_2024_1303_Fig1_HTML.jpg

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