Hypertension and obesity moderate the relationship between β-amyloid and cognitive decline in midlife

Background: This study tested if central obesity, hypertension, or depressive symptoms moderated the relationship between beta-amyloid (A beta) and longitudinal cognitive performance in late middle-aged adults enriched for Alzheimer's disease (AD) risk. Methods: Participants (n = 207; ages = 0-70 years; 73% parental AD) in the Wisconsin Registry for Alzheimer's Prevention study completed 3+ neuropsychological evaluations and a [C-11]PiB positron emission tomography scan or lumbar puncture. Linear mixed-effects regression models tested interactions of risk factor X Ab X visit age on longitudinal Verbal Learning & Memory and Speed & Flexibility factor scores. Results: The relationship between Ab and Verbal Learning & Memory decline was moderated by hypertension (chi(2)((1)) = 3.85, P = .04) and obesity (chi(2)((1)) = 6.12, P = .01); those with both elevated Ab and the risk factor declined at faster rates than those with only elevated Ab or elevated risk factors. Conclusion: In this cohort, hypertension and obesity moderated the relationship between Ab and cognitive decline. Published by Elsevier Inc. on behalf of the Alzheimer's Association.