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Article Dans Une Revue Alzheimer's & Dementia : the Journal of the Alzheimer's Association Année : 2023

Associations among hypertension, dementia biomarkers, and cognition: The MEMENTO cohort

1 BPH - Bordeaux population health
2 Unité de qualitique et d'évaluation médicale - pole Santé Publique
3 Université Paris-Saclay, CEA, ISAS/DMN/SRMA, 91191, Gif/Yvette, France
4 CATI - Centre d'Acquisition et de Traitement des Images [Paris] = CATI Multicenter Neuroimaging Platform
5 CRICM - Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière
6 IM2A - Institut de la Mémoire et de la Maladie d'Alzheimer [CHU Pitié-Salpétriêre]
7 ICube - Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie
8 BioCANVAS / U942 - Biomarqueurs CArdioNeuroVASCulaires
9 CHU Lariboisière-François Widal
10 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
11 UB - Université de Bordeaux
12 Centre Mémoire de Ressources et de Recherches [Bordeaux]
13 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
14 PSNREC - Neuropsychiatrie : recherche épidémiologique et clinique
15 UM - Université de Montpellier
16 INS - Institut de Neurosciences des Systèmes
17 LPPL - Laboratoire de Psychologie des Pays de la Loire
18 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
19 Service de neurologie [Amiens]
20 LNFP - Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559
21 CHU Amiens-Picardie
22 Service de neurologie [Rouen]
23 GMFC - Génétique du cancer et des maladies neuropsychiatriques
24 Pôle Psychiatrie et Neurologie [Grenoble]
25 UA UFR SM - Université des Antilles - UFR des sciences médicales Hyacinthe Bastaraud
26 NEMESIS-CRICM - Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière
27 Epidémiologie et Biostatistique [Bordeaux]
28 Institut National de la Santé et de la Recherche Médicale (INSERM), U708, Neuroepidemiology, Paris, France

Résumé

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.
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Dates et versions

hal-03890183 , version 1 (16-02-2024)

Identifiants

Citer

Jérémie Lespinasse, Geneviève Chêne, Jean‐francois Mangin, Bruno Dubois, Frederic Blanc, et al.. Associations among hypertension, dementia biomarkers, and cognition: The MEMENTO cohort. Alzheimer's & Dementia : the Journal of the Alzheimer's Association, 2023, 19 (6), pp.2332-2342. ⟨10.1002/alz.12866⟩. ⟨hal-03890183⟩
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