Hypertension, Cognition, and the Brain in Older Adults

高血压、认知和老年人的大脑

• 批准号: 7097247
• 负责人: Shari Waldstein
• 金额: $ 25.87万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE COUNTY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2009-07-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7097247
• 关键词: adipose tissue; angiography; bioimaging /biomedical imaging; biomarker; blood chemistry; brain disorders; brain morphology; cardiovascular disorder risk; cardiovascular stress test; clinical research; cognition disorders; dementia; glucose tolerance; glucose tolerance test; human old age (65+); hyperinsulinism; hyperlipidemia; hypertension; interview; magnetic resonance imaging; metabolic syndrome; neuropsychological tests; single photon emission computed tomography; stomach; stroke; white matter

DESCRIPTION (provided by applicant): Hypertension, dyslipidemia, hyperinsulinemia, glucose intolerance, and abdominal adiposity are facets of the metabolic syndrome, and are predictors of stroke and vascular dementia. Prior to overt cerebrovascular disease, subtle cognitive deficits are noted in persons with these cardiovascular (CV) risk factors. However, the biological mechanisms linking CV risk factors to poorer cognitive function are poorly understood. Subtle deficits in cognitive function and accompanying brain abnormalities may constitute early markers of elevated cerebrovascular risk among older adults with CV risk factors. The first specific aim of this competing continuation project is to examine whether, in 250 stroke-free, non-demented and non-diabetic older adults (ages 60-80+), 90 from our initial R29 project combined with 160 from this proposed project, CV risk factors - systolic and diastolic blood pressure, blood glucose, insulin, dyslipidemia, and abdominal adiposity - are associated with the poorer outcomes on: (1) neuropsychological test performance; (2) magnetic resonance imaging (MRI) ratings of white matter hyperintensities, silent infarction, and brain atrophy; (3) magnetic resonance angiography (MRA) ratings of stenosis of the large cerebral and cervicocerebral arteries; and (4) relative ratios of cerebral:cerebellar perfusion as assessed by single photon emission computed tomography (SPECT). The second specific aim is to examine whether MRI, MRA, and SPECT indices of subtle brain abnormalities mediate the relation between CV risk factors and poorer cognitive function. The cumulative burden of the CV risk factors and brain abnormalities will be examined in relation to domains of cognitive function, as will individual risk factors and brain abnormalities. To our knowledge, this will be the first study to examine whether several interrelated CV risk factors are associated with diminished cognitive function via several biologically plausible brain mechanisms in otherwise healthy older adults. Structural equation modeling will be used to examine patterns of interrelations among these variables and directly test brain abnormalities as potential mediators of the CV risk factor-cognition relation. Understanding the pathogenesis of cognitive impairment associated with CV risk factors in older adults may lead to enhanced efforts in prevention and intervention to reduce cerebrovascular risk, preserve cognitive functioning, and improve quality of life.

描述（由申请人提供）：高血压，血脂异常，高胰岛素血症，葡萄糖不耐症和腹部肥胖性是代谢综合征的方面，是中风和血管痴呆的预测指标。在明显的脑血管疾病之前，患有这些心血管（CV）危险因素的人会注意到细微的认知缺陷。但是，将简历危险因素与较差认知功能联系起来的生物学机制知之甚少。认知功能和随附的脑异常的细微缺陷可能构成患有CV风险因素的老年人脑血管风险升高的早期标志。 The first specific aim of this competing continuation project is to examine whether, in 250 stroke-free, non-demented and non-diabetic older adults (ages 60-80+), 90 from our initial R29 project combined with 160 from this proposed project, CV risk factors - systolic and diastolic blood pressure, blood glucose, insulin, dyslipidemia, and abdominal adiposity - are associated with the poorer outcomes on: （1）神经心理学测试表现； （2）白质超强度，无声梗塞和脑萎缩的磁共振成像（MRI）； （3）大脑和颈椎动脉狭窄的磁共振血管造影（MRA）； （4）通过单光子发射计算机断层扫描（SPECT）评估的大脑：小脑灌注的相对比。第二个具体目的是检查MRI，MRA和细微脑异常的SPECT指数是否介导了CV风险因素与较差的认知功能之间的关系。 CV风险因素和脑部异常的累积负担将与认知功能领域有关，单个风险因素和脑部异常也将与认知功能的领域有关。据我们所知，这将是首次研究通过在其他健康的老年人中通过几种生物学上合理的大脑机制来降低认知功能的几个相互关联的CV风险因素。结构方程模型将用于检查这些变量之间的相互关系模式，并直接测试脑异常，作为CV风险因素认知关系的潜在介体。了解老年人与简历风险因素相关的认知障碍的发病机理可能会导致预防和干预措施的努力，以减少脑血管风险，保留认知功能并改善生活质量。