Hostname: page-component-745bb68f8f-b95js Total loading time: 0 Render date: 2025-02-04T01:52:24.184Z Has data issue: false hasContentIssue false
  • English
  • Français

The association between systolic blood pressure variability with depression, cognitive decline and white matter hyperintensities: the 3C Dijon MRI study

Published online by Cambridge University Press:  27 September 2017

P. J. Tully ,
S. Debette  and
C. Tzourio
P. J. Tully*
Affiliation:
University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team HEALTHY, UMR1219, Bordeaux, France Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, Australia
S. Debette
Affiliation:
University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team HEALTHY, UMR1219, Bordeaux, France Department of Neurology, Bordeaux University Hospital, Bordeaux, France Department of Neurology, Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
C. Tzourio
Affiliation:
University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team HEALTHY, UMR1219, Bordeaux, France CHU de Bordeaux, Pole de sante publique, Service d'information medicale, Bordeaux, France
*
Author for correspondence: P. J. Tully, E-mail: phillip.tully@adelaide.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Accumulating evidence links blood pressure variability (BPV) with white matter hyperintensities (WMH) and stroke. The longitudinal association between BPV with late onset depression (LOD) and cognitive decline remains unexplored.

Methods

Prospective cohort study of 2812 participant's age ⩾65 years (median age 72 years, 63.6% female) without dementia or stroke. Serial clinic visits assessed blood pressure, cognitive function, depression disorder, and depressive symptoms. A brain magnetic resonance imaging (MRI) substudy was performed in 1275 persons to examine possible associations with WMH.

Results

The interaction between symptomatic LOD and systolic BPV was associated with cognitive decline on the Isaac Set Test [slope −4.45; 95% confidence interval (CI) −8.92 to −0.16, p = 0.04], Benton Visual Retention Test (slope −0.89; 95% CI −1.77 to −0.01, p = 0.049), Mini Mental State Examination (slope −1.08; 95% CI −1.86 to −0.30, p = 0.007) and Finger Tapping Test (slope −7.53; 95% CI −13.71 to −1.34, p = 0.017) but not Trail Making Test-A or -B/A. The MRI substudy demonstrated that systolic BPV was associated with cognitive decline via interactions with depression and total WMH volume, but this was not dependent on either deep or periventricular WMH volumes.

Conclusions

The findings show that the interaction between systolic BPV with symptomatic depression and WMH increases cognitive decline in persons ⩾65 years of age. Future work could extend these findings by examining systolic BPV in relation to cognitive decline and WMH in older populations with depression.

Keywords

Blood pressureblood pressure variabilitydepressiongeriatric psychiatrymild cognitive impairmentwhite matter hyperintensity
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 9 , July 2018 , pp. 1444 - 1453
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, GS (2001) ‘The depression-executive dysfunction syndrome of late life’: a specific target for D3 agonists? American Journal of Geriatric Psychiatry 9, 22–29.Google Scholar
Alperovitch, A et al. (2014) Blood pressure variability and risk of dementia in an elderly cohort, the Three-City study. Alzheimers and Dementia 10, S330–S337.Google Scholar
Alpérovitch, A et al. (2015) Primary prevention with lipid lowering drugs and long term risk of vascular events in older people: population based cohort study. British Medical Journal 350, h2335.Google Scholar
Amenta, F et al. (2008) Nicardipine: a hypotensive dihydropyridine-type calcium antagonist with a peculiar cerebrovascular profile. Clinical Experiments in Hypertension 30, 808–826.CrossRefGoogle ScholarPubMed
Armitage, SG (1946) An analysis of certain psychological tests used for the evaluation of brain injury. Psychological Monographs 60, Whole No. 277, i–48.Google Scholar
Benton, AL (1945) A visual retention test for clinical use. Archives of Neurology and Psychiatry 54, 212–216.Google Scholar
Brickman, AM et al. (2010) Long-term blood pressure fluctuation and cerebrovascular disease in an elderly cohort. Archives of Neurology 67, 564–569.CrossRefGoogle Scholar
Brindel, P et al. (2006) Prevalence, awareness, treatment, and control of hypertension in the elderly: the Three City study. Journal of Hypertension 24, 51–58.Google Scholar
Casamassima, F et al. (2010) L-type calcium channels and psychiatric disorders: a brief review. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 153B, 1373–1390.Google Scholar
Conway, KS et al. (2015) Relationship between 24-hour ambulatory blood pressure and cognitive function in community-living older adults: the UCSD ambulatory blood pressure study. American Journal of Hypertension 28, 1444–1452.Google Scholar
Dolan, E and O'Brien, E (2015) Is it daily, monthly, or yearly blood pressure variability that enhances cardiovascular risk? Current Cardiology Reports 17, 93.Google Scholar
Folstein, MF, Folstein, SE and McHugh, PR (1975) ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Grolleau, A et al. (2008) Psychotropic drug use and correspondence with psychiatric diagnoses in the mental health in the general population survey. L'Encephale 34, 352–359.Google Scholar
Gunstad, J et al. (2005) Blood pressure variability and white matter hyperintensities in older adults with cardiovascular disease. Blood Pressure 14, 353–358.Google Scholar
Havlik, RJ et al. (2002) Variability in midlife systolic blood pressure is related to late-life brain white matter lesions: the Honolulu-Asia Aging study. Stroke 33, 26–30.Google Scholar
Hickie, I et al. (2005) Reduced hippocampal volumes and memory loss in patients with early- and late-onset depression. The British Journal of Psychiatry 186, 197–202.CrossRefGoogle ScholarPubMed
Isaacs, B and Kennie, AT (1973) The set test as an aid to the detection of dementia in old people. The British Journal of Psychiatry 123, 467–470.Google Scholar
Jayaweera, HK et al. (2016) Episodic memory in depression: the unique contribution of the anterior caudate and hippocampus. Psychological Medicine 46, 2189–2199.Google Scholar
Lecrubier, Y et al. (1997) The MINI international neuropsychiatric interview (M.I.N.I.) A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry 12, 224–231.Google Scholar
Maillard, P et al. (2008) An automated procedure for the assessment of white matter hyperintensities by multispectral (T1, T2, PD) MRI and an evaluation of its between-centre reproducibility based on two large community databases. Neuroradiology 50, 31–42.CrossRefGoogle Scholar
Marijnissen, RM et al. (2017) Metabolic dysregulation and late-life depression: a prospective study. Psychological Medicine 47, 1041–1052.Google Scholar
Nagai, M et al. (2012) Visit-to-visit blood pressure variations: new independent determinants for cognitive function in the elderly at high risk of cardiovascular disease. Journal of Hypertension 30, 1556–1563.Google Scholar
Naismith, SL et al. (2012) The neurobiology of depression in later-life: clinical, neuropsychological, neuroimaging and pathophysiological features. Progress in Neurobiology 98, 99–143.Google Scholar
O'Brien, JT et al. (1994) The differentiation of depression from dementia by temporal lobe magnetic resonance imaging. Psychological Medicine 24, 633–640.CrossRefGoogle ScholarPubMed
Parati, G et al. (2013) Assessment and management of blood-pressure variability. Nature Reviews Cardiology 10, 143–155.Google Scholar
Pimontel, MA et al. (2013) The external validity of MRI-defined vascular depression. The American Journal of Geriatric Psychiatry 21, S66–S67.Google Scholar
Qiu, C, Winblad, B and Fratiglioni, L (2005) The age-dependent relation of blood pressure to cognitive function and dementia. The Lancet Neurology 4, 487–499.Google Scholar
Radloff, LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401.Google Scholar
Riddle, M et al. (in press) Longitudinal cognitive outcomes of clinical phenotypes of late-life depression. The American Journal of Geriatric Psychiatry.Google Scholar
Sabayan, B et al. (2013) Association of visit-to-visit variability in blood pressure with cognitive function in old age: prospective cohort study. British Medical Journal 347, f4600.Google Scholar
Sanchez-Cubillo, I et al. (2009) Construct validity of the Trail Making Test: role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. Journal of the International Neuropsychological Society 15, 438–450.Google Scholar
Scheltens, P et al. (1992) White matter lesions on magnetic resonance imaging in clinically diagnosed Alzheimer's disease. Evidence for heterogeneity. Brain 115(Pt 3), 735–748.Google Scholar
Scuteri, A et al. (2009) Decreased nocturnal systolic blood pressure fall in older subjects with depression. Aging Clinical and Experimental Research 21, 292–297.CrossRefGoogle ScholarPubMed
Sheehan, DV et al. (1998) The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59, 22–33.Google ScholarPubMed
Sneed, JR et al. (2008) The vascular depression subtype: evidence of internal validity. Biological Psychiatry 64, 491–497.CrossRefGoogle ScholarPubMed
Sneed, JR, Roose, SP and Sackeim, HA (2006) Vascular depression: a distinct diagnostic subtype? Biological Psychiatry 60, 1295–1298.Google Scholar
Steffens, DC et al. (2011) Change in hippocampal volume on magnetic resonance imaging and cognitive decline among older depressed and nondepressed subjects in the neurocognitive outcomes of depression in the elderly study. American Journal of Geriatric Psychiatry 19, 4–12.CrossRefGoogle ScholarPubMed
Symonides, B et al. (2014) Does the control of negative emotions influence blood pressure control and its variability? Blood Pressure 23, 323–329.Google Scholar
Tai, C et al. (2015) Prognostic significance of visit-to-visit systolic blood pressure variability: a meta-analysis of 77,299 patients. Journal of Clinical Hypertension (Greenwich) 17, 107–115.Google Scholar
Taragano, FE, Bagnatti, P and Allegri, RF (2005) A double-blind, randomized clinical trial to assess the augmentation with nimodipine of antidepressant therapy in the treatment of ‘vascular depression’. International Psychogeriatrics 17, 487–498.Google Scholar
Taylor, WD, Aizenstein, HJ and Alexopoulos, GS (2013) The vascular depression hypothesis: mechanisms linking vascular disease with depression. Molecular Psychiatry 18, 963–974.CrossRefGoogle ScholarPubMed
Taylor, WD, Steffens, DC and Krishnan, KR (2006) Psychiatric disease in the twenty-first century: the case for subcortical ischemic depression. Biological Psychiatry 60, 1299–1303.Google Scholar
The 3C Study Group (2003) Vascular factors and risk of dementia: design of the Three-City study and baseline characteristics of the study population. Neuroepidemiology 22, 316–325.Google Scholar
Torres, MJ et al. (2015) Poor nutritional status is associated with a higher risk of falling and fracture in elderly people living at home in France: the Three-City cohort study. Osteoporosis International 26, 2157–2164.CrossRefGoogle ScholarPubMed
Tully, PJ et al. (2016a) Dementia risk with antihypertensive use and blood pressure variability: a cohort study. Neurology 87, 601–608.Google Scholar
Tully, PJ et al. (2016b) Diuretic antihypertensive drugs and incident dementia risk: a systematic review, meta-analysis and meta-regression of prospective studies. Journal of Hypertension 34, 1027–1035.Google Scholar
Tully, PJ et al. (2016c) The APOE epsilon 4 polymorphism does not predict late onset depression: the Three-City Study. Neurobiology of Aging 40, 191.e199–191.e110.CrossRefGoogle Scholar
Tzourio, C, Laurent, S and Debette, S (2014) Is hypertension associated with an accelerated aging of the brain? Hypertension 63, 894–903.Google Scholar
Virtanen, R et al. (2003) Anxiety and hostility are associated with reduced baroreflex sensitivity and increased beat-to-beat blood pressure variability. Psychosomatic Medicine 65, 751–756.Google Scholar
Webb, AJ et al. (2010) Effects of antihypertensive-drug class on interindividual variation in blood pressure and risk of stroke: a systematic review and meta-analysis. The Lancet 375, 906–915.Google Scholar
Yano, Y et al. (2014) Long-term blood pressure variability throughout young adulthood and cognitive function in midlife: the coronary artery risk development in young adults (CARDIA) study. Hypertension 64, 983–988.CrossRefGoogle ScholarPubMed
Supplementary material: File

Tully et al supplementary material

Tully et al supplementary material 1

Download Tully et al supplementary material(File)
File 584.3 KB