Key result
Higher SBP is linked to ~0.15-SD lower cognitive scores per 10 mmHg in Alzheimer's mutation carriers.
Why the study?
The Dominantly Inherited Alzheimer Network study provided an opportunity to evaluate the relationships between blood pressure and cognition in early to mid-adulthood autosomal-dominant Alzheimer's disease mutation carriers and non-carrier family members.
Is higher systolic or diastolic blood pressure in early-to-mid adulthood associated with poorer cross-sectional or longitudinal cognitive performance in individuals with and without autosomal-dominant Alzheimer's disease mutations?
Cohort (n=528)
Investigators carrying out assessments and some participants remain blind to mutation status
Yes
Is higher systolic or diastolic blood pressure in early-to-mid adulthood associated with poorer cross-sectional or longitudinal cognitive performance in individuals with and without autosomal-dominant Alzheimer's disease mutations?
Higher systolic blood pressure in early-to-mid adulthood is independently and cross-sectionally associated with poorer cognitive function in individuals carrying autosomal-dominant Alzheimer's disease mutations, even after adjusting for CSF amyloid biomarkers.
Answers are grounded in this paper and cite their sources.
Higher SBP may warrant monitoring in AD mutation carriers; leaves open whether BP control alters cognitive trajectories.
BACKGROUND: The Dominantly Inherited Alzheimer Network (DIAN) is a longitudinal observational study that collects data on cognition, blood pressure (BP), and other variables from autosomal-dominant Alzheimer's disease mutation carriers (MCs) and non-carrier (NC) family members in early to mid-adulthood, providing a unique opportunity to evaluate BP and cognition relationships in these populations. METHOD: We examined cross-sectional and longitudinal relationships between systolic and diastolic BP and cognition in DIAN MC and NC. RESULTS: Data were available from 528 participants, who had a mean age of 38 (SD = 11) and were 42% male and 61% MCs, at a median follow-up of 2 years. Linear-multilevel models found only cross-sectional associations in the MC group between higher systolic BP and poorer performance on language (β = -0.181 [-0.318, -0.044]), episodic memory (-0.212 [-0.375, -0.049]), and a composite cognitive measure (-0.146 [-0.276, -0.015]). In NCs, the relationship was cross-sectional only and present for language alone. DISCUSSION: Higher systolic BP was cross-sectionally but not longitudinally associated with poorer cognition, particularly in MCs. BP may influence cognition gradually, but further longitudinal research is needed.
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Xu et al. (2023) conducted a cohort in Autosomal-dominant Alzheimer's disease mutation carriers and non-carrier family members (n=528). Higher systolic blood pressure (per 10 mmHg increase) vs. Lower systolic blood pressure / non-carrier family members was evaluated on Baseline composite cognitive z-score in autosomal-dominant Alzheimer's disease mutation carriers (beta -0.146 per 10 mmHg increase, 95% CI -0.276 to -0.015, p=0.029). Higher systolic blood pressure was cross-sectionally associated with poorer composite cognitive performance in Alzheimer's mutation carriers (β = -0.146, 95% CI -0.276 to -0.015, P = 0.029).
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