Associations among hypertension, dementia biomarkers, and cognition: The MEMENTO cohort
Alzheimer's & Dementia. 2022-12-04; :
DOI: 10.1002/alz.12866
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Lespinasse J(1)(2), Chêne G(1)(2), Mangin JF(3)(4), Dubois B(5)(6), Blanc F(7), Paquet C(8), Hanon O(9), Planche V(10), Gabelle A(11), Ceccaldi M(12), Annweiler C(13), Krolak-Salmon P(14), Godefroy O(15), Wallon D(16), Sauvée M(17)(18), Bergeret S(19), Chupin M(3), Proust-Lima C(1), Dufouil C(1)(2); MEMENTO study group.
Author information:
(1)Inserm Research Center « Bordeaux Population Health », Bordeaux School of
Public Health, CIC 1401-EC, Bordeaux University, Bordeaux, France.
(2)Pôle de santé publique, Centre Hospitalier Universitaire (CHU) de Bordeaux,
Bordeaux, France.
(3)CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Paris, France.
(4)Université Paris-Saclay, CEA, CNRS, Neurospin, UMR9027 Baobab,
Gif-sur-Yvette, France.
(5)Sorbonne Université, CNRS, INSERM, Laboratoire d’Imagerie Biomédicale, Paris,
France.
(6)Sorbonne-Université, Service des maladies cognitives et comportementales et
Institut de la mémoire et de la maladie d’Alzheimer (IM2A), Hôpital de la
Salpêtrière, Paris, AP-PH, France.
(7)Univ. Strasbourg, CNRS, ICube laboratory, UMR 7357, Fédération de Médecine
Translationnelle de Strasbourg, Centre Mémoire de Ressources et de Recherches,
Departement de Gériatrie, Strasbourg, France.
(8)Univ. Paris, Inserm U1144, GHU APHP Nord Lariboisière Fernand-Widal, Paris,
France.
(9)Univ. de Paris, EA 4468, Service de Gériatrie, AP-HP, Hôpital Broca, Paris,
France.
(10)Univ. Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives,
Centre Mémoire de Ressources et de Recherches, Pôle de Neurosciences Cliniques,
CHU de Bordeaux, Bordeaux, France.
(11)Univ. Montpellier, i-site MUSE, Inserm U1061, Centre Mémoire de Ressources
et de Recherches, Pôle de Neurosciences, Département de Neurologie, CHU de
Montpellier, Montpellier, France.
(12)Univ. Aix Marseille, Inserm UMR 1106, Institut de Neurosciences des
Systèmes, Centre Mémoire de Ressources et de Recherches, Département de
Neurologie et de Neuropsychologie, AP-HM, Marseille, France.
(13)Univ. Angers, UPRES EA 4638, Centre Mémoire de Ressources et de Recherches,
Département de Gériatrie, CHU d’Angers, Angers, France.
(14)Univ. Lyon, Inserm U1028, CNRS UMR5292, Centre de Recherche en Neurosciences
de Lyon, Centre Mémoire Ressource et Recherche de Lyon (CMRR), Hôpital des
Charpennes, Hospices Civils de Lyon, Lyon, France.
(15)Neurology Departement and Functional Neurosciences Lab. (UR UPJV 4559),
Amiens University Hospital, Amiens, France.
(16)Normandie Univ, UNIROUEN, Inserm U1245, CHU Rouen, Department of Neurology
and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404,
Rouen, France.
(17)CMRR Grenoble Arc Alpin, CHU Grenoble, Grenoble, France.
(18)Laboratoire de Psychologie et NeuroCognition: LPNC CNRS 5105, Université
Grenoble Alpes, Grenoble, France.
(19)Département de Médecine Nucléaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris,
France.
INTRODUCTION: Approximately 40% of dementia cases could be delayed or prevented
acting on modifiable risk factors including hypertension. However, the
mechanisms underlying the hypertension-dementia association are still poorly
understood.
METHODS: We conducted a cross-sectional analysis in 2048 patients from the
MEMENTO cohort, a French multicenter clinic-based study of outpatients with
either isolated cognitive complaints or mild cognitive impairment. Exposure to
hypertension was defined as a combination of high blood pressure (BP) status and
antihypertensive treatment intake. Pathway associations were examined through
structural equation modeling integrating extensive collection of neuroimaging
biomarkers and clinical data.
RESULTS: Participants treated with high BP had significantly lower cognition
compared to the others. This association was mediated by higher
neurodegeneration and higher white matter hyperintensities load but not by
Alzheimer’s disease (AD) biomarkers.
DISCUSSION: These results highlight the importance of controlling hypertension
for prevention of cognitive decline and offer new insights on mechanisms
underlying the hypertension-dementia association.
HIGHLIGHTS: Paths of hypertension-cognition association were assessed by
structural equation models. The hypertension-cognition association is not
mediated by Alzheimer’s disease biomarkers. The hypertension-cognition
association is mediated by neurodegeneration and leukoaraiosis. Lower cognition
was limited to participants treated with uncontrolled blood pressure. Blood
pressure control could contribute to promote healthier brain aging.
© 2022 The Authors. Alzheimer’s & Dementia published by Wiley Periodicals LLC on
behalf of Alzheimer’s Association.
DOI: 10.1002/alz.12866
PMID: 36464896