White matter microstructure disruptions mediate the adverse relationships between hypertension and multiple cognitive functions in cognitively intact older adults
Journal
NeuroImage
Journal Volume
197
Pages
109-119
Date Issued
2019
Author(s)
Abstract
Although hypertension is a prominent vascular risk factor for late-life cognitive decline, the underlying pathophysiological mechanism remains unclear. Accordingly, the aim of this study was to examine the role of white matter microstructural integrity in hypertension-related cognitive detriments. We recruited 66 cognitively normal older adults, comprising 41 hypertensive patients and 25 normotensive controls. All participants underwent a comprehensive neuropsychological battery. White matter microstructural integrity was assessed using a tract-based automatic analysis approach derived from diffusion spectrum imaging. Mediating effects of white matter integrity were evaluated using structural equation modeling analyses. The results revealed that hypertensive older adults displayed poorer processing speed, executive function, and memory encoding. Lower white matter microstructural integrity was observed in the hypertensive elderly patients, primarily in long-range association fiber bundles. In particular, low microstructural integrity in specific tract bundles connecting frontal and posterior cerebral regions was found to underlie the adverse relationships between hypertension and multiple cognitive domains, including processing speed, executive function, memory encoding, and memory retention. Our findings suggest that hypertension may impair multiple cognitive functions by undermining white matter microstructures, even in cognitively intact older adults, thus further highlighting the necessity of monitoring vascular health to prevent cognitive decline. ? 2019 Elsevier Inc.
SDGs
Other Subjects
adult; age distribution; aged; Article; brain function; brain region; clinical article; cognition; cognition assessment; controlled study; diffusion tensor imaging; disease association; executive function; female; geriatric patient; human; hypertension; image analysis; image processing; male; memory; neuropsychological test; pathophysiology; priority journal; structural equation modeling; tissue structure; very elderly; voxel based morphometry; white matter; brain; cognition; complication; diffusion weighted imaging; hypertension; middle aged; pathology; physiology; psychology; white matter; Aged; Aged, 80 and over; Brain; Cognition; Diffusion Magnetic Resonance Imaging; Female; Humans; Hypertension; Male; Middle Aged; Neuropsychological Tests; White Matter
Publisher
Academic Press Inc.
Type
journal article