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The association between systolic blood pressure variability with depression, cognitive decline and white matter

P J Tully1, S Debette1, C Tzourio1

  • 1University of Bordeaux,Inserm,Bordeaux Population Health Research Center,team HEALTHY,UMR1219,Bordeaux,France.

Psychological Medicine
|September 28, 2017
PubMed

Insights

Systolic blood pressure variability (BPV) combined with symptomatic depression and white matter hyperintensities (WMH) accelerates cognitive decline in older adults. This interaction significantly impacts cognitive function, highlighting a critical link between vascular health and brain aging.

Area of Science:

  • Neurology
  • Gerontology
  • Cardiovascular Research

Background:

  • Blood pressure variability (BPV) is increasingly linked to white matter hyperintensities (WMH) and stroke.
  • The longitudinal relationship between BPV, late-onset depression (LOD), and cognitive decline is not well understood.

Purpose of the Study:

  • To investigate the association between BPV and cognitive decline in older adults, specifically examining the roles of late-onset depression and white matter hyperintensities.
  • To explore the interaction between BPV, symptomatic depression, and WMH in relation to cognitive function in individuals aged 65 and older.

Main Methods:

  • A prospective cohort study involving 2812 participants (age ≥65 years) without dementia or stroke.
  • Assessment of blood pressure, cognitive function, and depressive symptoms through serial clinic visits.
  • A brain MRI substudy in 1275 participants to evaluate white matter hyperintensities (WMH).

Main Results:

  • The interaction between symptomatic late-onset depression (LOD) and systolic BPV was significantly associated with cognitive decline across multiple cognitive tests.
  • Systolic BPV interacted with depression and total WMH volume to predict cognitive decline, independent of specific WMH locations (deep or periventricular).

Conclusions:

  • The combination of systolic BPV, symptomatic depression, and WMH significantly exacerbates cognitive decline in older adults (≥65 years).
  • Further research is warranted to explore these associations in diverse older populations with depression.
Abstract

Keywords:
Blood pressureblood pressure variabilitydepressiongeriatric psychiatrymild cognitive impairmentwhite matter hyperintensity

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