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P2‐604: RISK REDUCTION IN ALZHEIMER'S DISEASE (RRAD): RATIONALE AND METHODS FOR A MULTICENTER CLINICAL TRIAL ASSESSING EXERCISE AND INTENSIVE VASCULAR RISK REDUCTION FOR THE PREVENTION OF DEMENTIA
Author(s) -
Kerwin Diana R.,
Zhang Rong,
Vidoni Eric D.,
Binder Ellen F.,
Burns Jeffrey M.,
Cullum Munro,
Gahan William,
Keller Jeffrey N.,
Hynan Linda,
Rossetti Heidi,
Stowe Ann,
Vongpatanasin Wanpen,
Zhu David C.
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.06.3014
Subject(s) - medicine , dementia , neurocognitive , blood pressure , disease , alzheimer's disease , cognitive decline , physical therapy , randomized controlled trial , physical medicine and rehabilitation , cognition , psychiatry
Medical). MABP was calculated using the equation 1/3(SBP) + 2/ 3(DBP) (Sesso et al., 2000). SWkM was assessed using the SWkM task of the SUCCAB (Pipingas et al., 2010). Diffusion MRI data was collected using a Siemans Trio 3T scanner and analysed using the NUNDA advanced diffusion pipeline (Alpert et al., 2016). Six white matter regions of interest were selected based upon previously identified associations with blood pressure as well as working memory. Multiple regression and mediation analysis was performed using SPSS (results considered significant if p<0.05). Results: After controlling for age, gender, education, BMI, and use of blood pressure medications, brachial and central MABP’s negatively predicted microstructural integrity within the fornix (brachial b1⁄4 -0.002, p1⁄40.017; central b1⁄4 -0.002, p1⁄40.020). Fornix microstructure predicted SWkM accuracy (b1⁄4 3.017, p1⁄40.005), but not response time (p1⁄40.431). While MABP’s did not directly predict SWkM accuracy (brachial p1⁄40.541; central p1⁄4 0.648), an indirect association via fornix microstructure was identified (brachial effect 1⁄4 -0.0063, 95% CI: -0.0139 -0.002; central effect 1⁄4 -0.0064; 95% CI: -0.0141 -0.002). Conclusions: Elevated MABP appears to predict poorer fornix microstructure. There also appears to be an indirect effect of elevated MABP on SWkM performance via a detrimental effect upon fornix integrity. Subsequently, modifying MABP, through medication or lifestyle interventions may support neurocognitive health in older adults at risk of advanced cognitive decline.