Hypertension is a major risk factor for cerebral infarction, intracranial hemorrhage, and vascular dementia, particularly among older adults. Prior to clinical manifestations of cerebrovascular disease, subtle neuropsychological deficits are noted in hypertensives of all age ranges. In older adults, hypertension is highly prevalent, and is considered a critical factor in cognitive aging. The underlying pathogenesis of this process is poorly understood. Subtle deficits in neuropsychological performance, and accompanying central nervous system abnormalities, may constitute early markers of elevated cerebrovascular risk among older hypertensives. In this proposal, it is hypothesized that hypertension will be associated with diminished neuropsychological function, increased microvascular disease, greater macrovascular disease, and reduced cerebral perfusion. These three central nervous system mechanisms will result in subtle neuropsychological deficits among non-demented, older hypertensives. The first specific aim of this project is to compare 100 unmedicated, mild-to-moderate essential hypertensives (ages 60-80) to 100 demographically comparable normotensives with respect to: (1) neuropsychological performance; (2) magnetic resonance imaging (MRI) ratings of microvascular disease involving periventricular and deep white matter; (3) magnetic resonance angiography (MRA) ratings of macrovascular disease of the cerebral and cervicocerebral arteries; and (4) relative ratios of cerebral:cerebellar perfusion assessed by single photon emission computed tomography (SPECT).
A second aim i s to examine MRI, MRA, and SPECT indices of microvascular disease, macrovascular disease, and cerebral perfusion as predictors of neuropsychological performance. This study will be the first to examine concomitantly three central nervous system mechanisms as predictors of neuropsychological function in older adults. Understanding the pathogenesis of hypertension-related cognitive impairment in older adults may lead to enhanced efforts in prevention, and intervention to reduce cerebrovascular risk and improve quality of life.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29AG015112-05
Application #
6488844
Study Section
Behavioral Medicine Study Section (BEM)
Program Officer
Wagster, Molly V
Project Start
1998-01-01
Project End
2004-09-29
Budget Start
2002-01-15
Budget End
2004-09-29
Support Year
5
Fiscal Year
2002
Total Cost
$92,122
Indirect Cost
Name
University of Maryland Balt CO Campus
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
City
Baltimore
State
MD
Country
United States
Zip Code
21250
Wendell, Carrington R; Zonderman, Alan B; Katzel, Leslie I et al. (2016) Nonlinear associations between plasma cholesterol levels and neuropsychological function. Neuropsychology 30:980-987
Kisser, Jason E; Allen, Allyssa J; Katzel, Leslie I et al. (2016) Relations of blood pressure and head injury to regional cerebral blood flow. J Neurol Sci 365:9-14
Sims Wright, Regina; Levy, Shellie-Anne T; Katzel, Leslie I et al. (2015) Fasting glucose and glucose tolerance as potential predictors of neurocognitive function among nondiabetic older adults. J Clin Exp Neuropsychol 37:49-60
Sims, R C; Katzel, L I; Lefkowitz, D M et al. (2014) Association of fasting glucose with subclinical cerebrovascular disease in older adults without Type 2 diabetes. Diabet Med 31:691-8
Sims, Regina C; Hosey, Megan; Levy, Shellie-Anne et al. (2014) Distinct functions of social support and cognitive function among older adults. Exp Aging Res 40:40-59
Spencer, Robert J; Wendell, Carrington R; Giggey, Paul P et al. (2013) Judgment of Line Orientation: an examination of eight short forms. J Clin Exp Neuropsychol 35:160-6
Spencer, Robert J; Wendell, Carrington R; Giggey, Paul P et al. (2013) Psychometric limitations of the mini-mental state examination among nondemented older adults: an evaluation of neurocognitive and magnetic resonance imaging correlates. Exp Aging Res 39:382-97
Waldstein, Shari R; Wendell, Carrington R; Lefkowitz, David M et al. (2012) Interactive relations of blood pressure and age to subclinical cerebrovascular disease. J Hypertens 30:2352-6
Wendell, Carrington Rice; Hosey, Megan M; Lefkowitz, David M et al. (2010) Depressive symptoms are associated with subclinical cerebrovascular disease among healthy older women, not men. Am J Geriatr Psychiatry 18:940-7
Waldstein, Shari R; Lefkowitz, David M; Siegel, Eliot L et al. (2010) Reduced cerebral blood flow in older men with higher levels of blood pressure. J Hypertens 28:993-8

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