Journal
ALZHEIMERS & DEMENTIA
Volume 19, Issue 5, Pages 1963-1973Publisher
WILEY
DOI: 10.1002/alz.12844
Keywords
aging; blood pressure; cognitive function; diffusion MRI; pulse pressure
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This study found that prolonged elevated pulse pressure (PP) predicts microstructural abnormalities in the brain, which may contribute to impaired executive function. APOE epsilon 4 carriers are more vulnerable to the adverse effects of high PP on brain microstructure.
Introduction Effects of chronic arterial stiffness on brain aging remain unclear. We, therefore, examined whether long-term trajectories of pulse pressure (PP) predicted brain microstructure, microstructure mediated PP-executive function associations, and APOE genotype modified PP-microstructure associations. Methods We examined associations of PP trajectories with brain microstructure measured using restriction spectrum imaging in 146 community-dwelling older adults, whether microstructure mediated PP trajectory-executive function associations, and whether PP-restriction spectrum imaging correlations were modified by APOE-epsilon 4 status. Results Participants with trajectories of high PP had lower restricted isotropic diffusion (RI) compared to those with low PP trajectories and PP-executive function associations were mediated by subcortical and white matter RI. High PP more strongly correlated with lower RI and higher hindered diffusion among APOE-epsilon 4 carriers than non-carriers. Discussion Prolonged elevated PP predicts microstructural abnormalities which may contribute to impaired executive function. APOE-epsilon 4 carriers may be most vulnerable to the adverse effects of PP on brain microstructure.
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