Association of midlife blood pressure to late-life cognitive decline and brain morphology

作者：Gary E. Swan, Charles DeCarli, Bruce Leonard Miller, T. Reed, Philip A. Wolf, Lisa M. Jack, Dorit Carmelli · 发表于：Neurology · 年份：1998 · DOI：10.1212/wnl.51.4.986 · 被引用次数：393 · 研究领域：Dementia and Cognitive Impairment Research、Advanced MRI Techniques and Applications、Functional Brain Connectivity Studies

OBJECTIVE: To investigate the association between midlife systolic blood pressure (SBP) and late-life cognitive decline and brain morphology in a sample of community-dwelling elderly men 68 to 79 years of age. METHODS: Subjects are surviving members from the prospective National Heart, Lung, and Blood Institute Twin Study (intake, 1969 to 1972) who, when examined for a fourth time in 1995 through 1997, underwent brain MRI and repeated assessment of neurobehavioral functioning. Quantification of the MR images determined cerebral volume and total volume of white matter hyperintensities (WMHIs) for 392 subjects. Midlife SBP levels measured in 1970, 1980, and 1985 were used to classify subjects into low, medium, and high midlife SBP categories. A 10-year change in performance on the Mini-Mental State Examination, Digit Symbol Substitution Test, Benton Visual Retention Test, and Verbal Fluency Test was also calculated for these subjects. For all reported analyses, patients were treated as genetically unrelated individuals. RESULTS: Subjects with high midlife SBP experienced a greater decline in cognitive performance and had larger WMHI volumes at follow-up in late life than did those with low midlife SBP. Decreased brain parenchyma and increased WMHI volumes were associated with decline in neurobehavioral functioning as measured in late life independent of age, education, and baseline levels of cognition. CONCLUSIONS: Midlife SBP is a significant predictor of both decline in cogni...