Les cahiers de l'année gérontologique

, Volume 5, Issue 3, pp 274–284

Composante vasculaire du déclin cognitif : les leçons tirées de deux études cliniques chez des personnes âgées, menées au CHU de Nancy

  • G. Watfa
  • A. Besozzi
  • S. Gautier
  • A. Kearney-Schwartz
  • A. Benetos
Article Original / Original Article
  • 77 Downloads

Résumé

Nous présentons ici des résultats issus de deux études cliniques, PARTAGE (sujets >80 ans institutionnalisés) et ADELAHYDE (sujets hypertendus âgés de 60 à 85 ans avec plainte mnésique) menées au CHU de Nancy. Les résultats de ces études montrent une implication de la rigidité artérielle sur les fonctions cognitives, et sur la leucoaraïose. Le suivi longitudinal de ces deux cohortes, actuellement réalisé, permettra de mieux comprendre le rôle du vieillissement artériel dans l’évolution des fonctions cognitives.

Mots clés

Hypertension Rigidité artérielle Déclin cognitif Vieillissement Leucoaraïose 

Vascular component of cognitive decline: Lessons learned from two clinical studies in old individuals conducted in Nancy university hospital

Abstract

We present results from two clinical studies, PARTAGE (institutionalized subjects >80 years) and ADELAHYDE (hypertensive subjects aged 60 to 85 years with memory complaints) conducted at the University Hospital of Nancy. The results of these studies show an involvement of arterial stiffness on cognitive function, and leukoaraiosis. The longitudinal follow-up of these two cohorts, currently performed, will enable us to better understand the role of arterial aging in the development of cognitive functions.

Keywords

Hypertension Arterial Stiffness Cognitive decline Aging Leukoaraiosis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Références

  1. 1.
    Lakatta EG (2003) Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part III: cellular and molecular clues to heart and arterial aging. Circulation 107:490–497PubMedCrossRefGoogle Scholar
  2. 2.
    Benetos A, Salvi P, Lacolley P (2011) Blood pressure regulation during the aging process: the end of the’ hypertension era’? J Hypertens 29:646–652PubMedCrossRefGoogle Scholar
  3. 3.
    Benetos A, Rudnichi A, Safar M, Guize L (1998) Pulse pressure and cardiovascular mortality in normotensive and hypertensive subjects. Hypertension 32:560–564PubMedCrossRefGoogle Scholar
  4. 4.
    Hofman A, Ott A, Breteler MM, et al (1997) Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer’s disease in the Rotterdam Study. Lancet 349:151–154PubMedCrossRefGoogle Scholar
  5. 5.
    Seshadri S, Beiser A, Selhub J, et al (2002) Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease. N Engl J Med 346:476–483PubMedCrossRefGoogle Scholar
  6. 6.
    Barnes DE, Yaffe K (2011) The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol 10:819–828PubMedCrossRefGoogle Scholar
  7. 7.
    Casserly I, Topol E (2004) Convergence of atherosclerosis and Alzheimer’s disease: inflammation, cholesterol, and misfolded proteins. Lancet 363:1139–1146PubMedCrossRefGoogle Scholar
  8. 8.
    O’Brien JT, Erkinjuntti T, Reisberg B, et al (2003) Vascular cognitive impairment. Lancet Neurol 2:89–98PubMedCrossRefGoogle Scholar
  9. 9.
    Benetos A, Watfa G, Hanon O, et al (2012) Pulse wave velocity is associated with 1-year cognitive decline in the elderly older than 80 years: the PARTAGE study. J Am Med Dir Assoc 13:239–243PubMedCrossRefGoogle Scholar
  10. 10.
    Kearney-Schwartz A, Rossignol P, Bracard S, et al (2009) Vascular structure and function is correlated to cognitive performance and white matter hyperintensities in older hypertensive patients with subjective memory complaints. Stroke 40:1229–1236PubMedCrossRefGoogle Scholar
  11. 11.
    Watfa G, Rossignol P, Kearney-Schwartz A et al (2010) Use of calcium channel blockers is associated with better cognitive performance in older hypertensive patients with subjective memory complaints. J Hypertens 28:2485–2493PubMedCrossRefGoogle Scholar
  12. 12.
    Benetos A, Buatois S, Salvi P, et al (2010) Blood pressure and pulse wave velocity values in the institutionalized elderly aged 80 and over: baseline of the PARTAGE study. J Hypertens 28:41–50PubMedCrossRefGoogle Scholar
  13. 13.
    Benetos A, Gautier S, Labat C, et al (2012) Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjects: the PARTAGE (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population) study. J Am Coll Cardiol 60:1503–1511PubMedCrossRefGoogle Scholar
  14. 14.
    Scuteri A, Brancati AM, Gianni W, et al (2005) Arterial stiffness is an independent risk factor for cognitive impairment in the elderly: a pilot study. J Hypertens 23:1211–1216PubMedCrossRefGoogle Scholar
  15. 15.
    Hanon O, Haulon S, Lenoir H, et al (2005) Relationship between arterial stiffness and cognitive function in elderly subjects with complaints of memory loss. Stroke 36:2193–2197PubMedCrossRefGoogle Scholar
  16. 16.
    Scuteri A, Tesauro M, Appolloni S, et al (2007) Arterial stiffness as an independent predictor of longitudinal changes in cognitive function in the older individual. J Hypertens 25:1035–1040PubMedCrossRefGoogle Scholar
  17. 17.
    Waldstein SR, Rice SC, Thayer JF, et al (2008) Pulse pressure and pulse wave velocity are related to cognitive decline in the Baltimore Longitudinal Study of Aging. Hypertension 51:99–104PubMedCrossRefGoogle Scholar
  18. 18.
    Poels MM, van Oijen M, Mattace-Raso FU, et al (2007) Arterial stiffness, cognitive decline, and risk of dementia: the Rotterdam study. Stroke 38:888–92PubMedCrossRefGoogle Scholar
  19. 19.
    Elias MF, Wolf PA, D’Agostino RB, et al (1993) Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study. Am J Epidemiol 138:353–364PubMedGoogle Scholar
  20. 20.
    Launer LJ, Ross GW, Petrovitch H, et al (2000) Midlife blood pressure and dementia: the Honolulu-Asia aging study. Neurobiol Aging 21:49–55PubMedCrossRefGoogle Scholar
  21. 21.
    Skoog I, Lernfelt B, Landahl S, et al (1996) 15-year longitudinal study of blood pressure and dementia. Lancet 347:1141–1145PubMedCrossRefGoogle Scholar
  22. 22.
    Tzourio C, Dufouil C, Ducimetiere P, Alperovitch A (1999) Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of Vascular Aging. Neurology 53:1948–1952Google Scholar
  23. 23.
    Harrington F, Saxby BK, McKeith IG, et al (2000) Cognitive performance in hypertensive and normotensive older subjects. Hypertension 36:1079–1082PubMedCrossRefGoogle Scholar
  24. 24.
    Glynn RJ, Beckett LA, Hebert LE, et al (1999) Current and remote blood pressure and cognitive decline. JAMA 281:438–45PubMedCrossRefGoogle Scholar
  25. 25.
    Molander L, Lovheim H, Norman T, et al (2008) Lower systolic blood pressure is associated with greater mortality in people aged 85 and older. J Am Geriatr Soc 56:1853–1859PubMedCrossRefGoogle Scholar
  26. 26.
    Forette F, Seux ML, Staessen JA, et al (2002) The prevention of dementia with antihypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study. Arch Intern Med 162:2046–2052PubMedCrossRefGoogle Scholar
  27. 27.
    Hanon O, Latour F, Seux ML, et al (2003) [Relationship between arterial pressure and cognitive functions. Data for the French Network on Alzheimer’s disease (REAL.FR)]. Rev Med Interne 24Suppl 3:292s–300s.PubMedCrossRefGoogle Scholar
  28. 28.
    Toescu EC, Verkhratsky A (2007) The importance of being subtle: small changes in calcium homeostasis control cognitive decline in normal aging. Aging Cell 6:267–273PubMedCrossRefGoogle Scholar
  29. 29.
    Farkas E, De Jong GI, Apro E, et al (2001) Calcium antagonists decrease capillary wall damage in aging hypertensive rat brain. Neurobiol Aging 22:299–309PubMedCrossRefGoogle Scholar
  30. 30.
    Tzourio C, Anderson C, Chapman N, et al (2003) Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. Arch Intern Med 163:1069–1075PubMedCrossRefGoogle Scholar
  31. 31.
    Hanon O, Pequignot R, Seux ML, et al (2006) Relationship between antihypertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints. J Hypertens 24:2101–2107PubMedCrossRefGoogle Scholar
  32. 32.
    McGuinness B, Todd S, Passmore P, Bullock R (2006) The effects of blood pressure lowering on development of cognitive impairment and dementia in patients without apparent prior cerebrovascular disease. Cochrane Database Syst Rev CD004034Google Scholar
  33. 33.
    Lithell H, Hansson L, Skoog I, et al (2003) The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hypertens 21:875–886PubMedCrossRefGoogle Scholar
  34. 34.
    Peters R, Beckett N, Forette F, et al (2008) Incident dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a doubleblind, placebo controlled trial. Lancet Neurol 7:683–689PubMedCrossRefGoogle Scholar
  35. 35.
    Gorelick PB, Nyenhuis D, American Society of Hypertension Writing G, et al (2012) Blood pressure and treatment of persons with hypertension as it relates to cognitive outcomes including executive function. J Am Soc Hypertens 6:309–315PubMedCrossRefGoogle Scholar
  36. 36.
    Zuccala G, Onder G, Pedone C, et al (2001) Hypotension and cognitive impairment: Selective association in patients with heart failure. Neurology 57:1986–1992PubMedCrossRefGoogle Scholar
  37. 37.
    Qiu C, Winblad B, Fratiglioni L (2005) The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol 4:487–499PubMedCrossRefGoogle Scholar
  38. 38.
    Kim JE, Shin JS, Jeong JH, et al (2009) Relationships between 24-Hour Blood Pressures, Subcortical Ischemic Lesions, and Cognitive Impairment. J Clin Neurol 5:139–145PubMedCrossRefGoogle Scholar
  39. 39.
    O’Rourke MF, Safar ME (2005) Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension 46:200–204PubMedCrossRefGoogle Scholar
  40. 40.
    Kuo HK, Chen CY, Liu HM, et al (2009) Metabolic risks, white matter hyperintensities, and arterial stiffness in high-functioning healthy adults. Int J Cardiol 143:184–191PubMedCrossRefGoogle Scholar
  41. 41.
    Hachinski VC, Potter P, Merskey H (1987) Leuko-araiosis. Arch Neurol 44:21–23PubMedCrossRefGoogle Scholar
  42. 42.
    Firbank MJ, Wiseman RM, Burton EJ, et al (2007) Brain atrophy and white matter hyperintensity change in older adults and relationship to blood pressure. Brain atrophy, WMH change and blood pressure. J Neurol 254:713–721Google Scholar
  43. 43.
    Pantoni L, Garcia JH (1995) The significance of cerebral white matter abnormalities 100 years after Binswanger’s report. A review. Stroke 26:1293–1301CrossRefGoogle Scholar
  44. 44.
    Markus HS, Hunt B, Palmer K, et al (2005) Markers of endothelial and hemostatic activation and progression of cerebral white matter hyperintensities: longitudinal results of the Austrian Stroke Prevention Study. Stroke 36:1410–1414PubMedCrossRefGoogle Scholar
  45. 45.
    Manolio TA, Burke GL, O’Leary DH, et al (1999) Relationships of cerebral MRI findings to ultrasonographic carotid atherosclerosis in older adults: the Cardiovascular Health Study. CHS Collaborative Research Group. Arterioscler Thromb Vasc Biol 19:356–365CrossRefGoogle Scholar
  46. 46.
    Pantoni L, Garcia JH (1997) Pathogenesis of leukoaraiosis: a review. Stroke 28:652–659PubMedCrossRefGoogle Scholar
  47. 47.
    Mosley TH, Jr., Knopman DS, Catellier DJ, et al (2005) Cerebral MRI findings and cognitive functioning: the Atherosclerosis Risk in Communities study. Neurology 64:2056–2062PubMedCrossRefGoogle Scholar
  48. 48.
    Sierra C, De La Sierra A, Salamero M, et al (2004) Silent cerebral white matter lesions and cognitive function in middle-aged essential hypertensive patients. Am J Hypertens 17:529–534PubMedCrossRefGoogle Scholar
  49. 49.
    Enzinger C, Fazekas F, Matthews PM, et al (2005) Risk factors for progression of brain atrophy in aging: six-year follow-up of normal subjects. Neurology 64:1704–1711PubMedCrossRefGoogle Scholar
  50. 50.
    Silbert LC, Nelson C, Howieson DB, et al (2008) Impact of white matter hyperintensity volume progression on rate of cognitive and motor decline. Neurology 71:108–113PubMedCrossRefGoogle Scholar
  51. 51.
    Nyenhuis DL, Gorelick PB, Geenen EJ, et al (2004) The pattern of neuropsychological deficits in Vascular Cognitive Impairment-No Dementia (Vascular CIND). Clin Neuropsychol 18:4149Google Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • G. Watfa
    • 1
  • A. Besozzi
    • 1
  • S. Gautier
    • 1
  • A. Kearney-Schwartz
    • 1
  • A. Benetos
    • 1
  1. 1.Service de gériatrie et CMRR du CHU de Nancyhôpital de BraboisVandoeuvre-lès-NancyFrance

Personalised recommendations