Pulse pressure trajectories predict brain microstructure in community-dwelling older adults: Associations with executive function and modification by APOE

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.

Automated summary

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.