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A. Shirsath M, O'Connor JD, Boyle R, Newman L, Knight SP, Hernandez B, Whelan R, Meaney JF, Kenny RA. Slower speed of blood pressure recovery after standing is associated with accelerated brain aging: Evidence from The Irish Longitudinal Study on Ageing (TILDA). CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100212. [PMID: 38445293 PMCID: PMC10912350 DOI: 10.1016/j.cccb.2024.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/17/2024] [Accepted: 02/02/2024] [Indexed: 03/07/2024]
Abstract
Background Impaired recovery of blood pressure (BP) in response to standing up is a prevalent condition in older individuals. We evaluated the relationship between the early recovery of hemodynamic responses to standing and brain health in adults over 50. Methods Participants from The Irish Longitudinal Study on Ageing (TILDA) (n=411; age 67.6 ± 7.3 years; 53.4 % women) performed an active stand challenge while blood pressure and heart rate were continuously monitored. The recovery of these parameters was determined as the slope of the BP and HR response, following the initial drop/rise after standing. We have previously reported a novel and validated measure of brain ageing using MRI data, which measures the difference between biological brain age and chronological age, providing a brain-predicted age difference (brainPAD) score. Results Slower recovery of systolic and diastolic BP was found to be significantly associated with higher brainPAD scores (i.e., biologically older brains), where a one-year increase in brainPAD was associated with a decrease of 0.02 mmHg/s and 0.01 mmHg/s in systolic and diastolic BP recovery, respectively, after standing. Heart rate (HR) recovery was not significantly associated with brainPAD score. Conclusion These results demonstrate that slower systolic and diastolic BP recovery in the early phase after standing is associated with accelerated brain aging in older individuals. This suggests that the BP response to standing, measured using beat-to-beat monitoring, has the potential to be used as a marker of accelerated brain aging, relying on a simple procedure and devices that are easily accessible.
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Affiliation(s)
- Morgana A. Shirsath
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - John D. O'Connor
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
- School of Engineering, Ulster University, Northern Ireland, UK
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Louise Newman
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - Silvin P. Knight
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - Belinda Hernandez
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College, University of Dublin, Ireland
- Global Brain Health Institute, Trinity College, Trinity College Dublin, Ireland
| | - James F. Meaney
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
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Doran S, Carey D, Knight S, Meaney JF, Kenny RA, De Looze C. Relationship between hippocampal subfield volumes and cognitive decline in healthy subjects. Front Aging Neurosci 2023; 15:1284619. [PMID: 38131011 PMCID: PMC10733466 DOI: 10.3389/fnagi.2023.1284619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
We examined the relationship between hippocampal subfield volumes and cognitive decline over a 4-year period in a healthy older adult population with the goal of identifying subjects at risk of progressive cognitive impairment which could potentially guide therapeutic interventions and monitoring. 482 subjects (68.1 years +/- 7.4; 52.9% female) from the Irish Longitudinal Study on Ageing underwent magnetic resonance brain imaging and a series of cognitive tests. Using K-means longitudinal clustering, subjects were first grouped into three separate global and domain-specific cognitive function trajectories; High-Stable, Mid-Stable and Low-Declining. Linear mixed effects models were then used to establish associations between hippocampal subfield volumes and cognitive groups. Decline in multiple hippocampal subfields was associated with global cognitive decline, specifically the presubiculum (estimate -0.20; 95% confidence interval (CI) -0.78 - -0.02; p = 0.03), subiculum (-0.44; -0.82 - -0.06; p = 0.02), CA1 (-0.34; -0.78 - -0.02; p = 0.04), CA4 (-0.55; -0.93 - -0.17; p = 0.005), molecular layer (-0.49; -0.87 - -0.11; p = 0.01), dentate gyrus (-0.57; -0.94 - -0.19; p = 0.003), hippocampal tail (-0.53; -0.91 - -0.15; p = 0.006) and HATA (-0.41; -0.79 - -0.03; p = 0.04), with smaller volumes for the Low-Declining cognition group compared to the High-Stable cognition group. In contrast to global cognitive decline, when specifically assessing the memory domain, cornu ammonis 1 subfield was not found to be associated with low declining cognition (-0.14; -0.37 - 0.10; p = 0.26). Previously published data shows that atrophy of specific hippocampal subfields is associated with cognitive decline but our study confirms the same effect in subjects asymptomatic at time of enrolment. This strengthens the predictive value of hippocampal subfield atrophy in risk of cognitive decline and may provide a biomarker for monitoring treatment efficacy.
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Affiliation(s)
- Simon Doran
- Department of Radiology, St James’s Hospital, Dublin, Ireland
- The Thomas Mitchell Centre for Advanced Medical Imaging, St James’s Hospital, Dublin, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Silvin Knight
- The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - James F. Meaney
- Department of Radiology, St James’s Hospital, Dublin, Ireland
- The Thomas Mitchell Centre for Advanced Medical Imaging, St James’s Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Dublin, Ireland
- The Mercer’s Institute for Successful Ageing (MISA), St James’s Hospital, Dublin, Ireland
| | - Céline De Looze
- The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Looze CD, Scarlett S, Newman L, Kenny RA. Sleep duration and disturbance are associated with orthostatic heart rate recovery: Findings from the Irish Longitudinal Study on Ageing. Sleep Health 2022; 8:654-662. [PMID: 36216751 DOI: 10.1016/j.sleh.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine a novel measurement of autonomic innervation, the early heart rate response to orthostasis, in relation to sleep duration and disturbance (actigraphy-based and self-reported) in healthy older adults. DESIGN Cross-sectional analyses of a nationally representative prospective cohort study, the Irish Longitudinal Study on Ageing (TILDA). PARTICIPANTS Nine hundred sixty community-dwelling adults aged 50 and over (mean age 65.6 ± 8.1; 53% women). MEASUREMENT Orthostatic heart rate response was measured during an active stand test. Beat-to-beat heart rate was monitored over 3 minutes using noninvasive digital photoplethysmography. Mean values at each 10-second time point after standing were generated and differences from baseline at each time point were used for analysis. Actigraphy-based sleep measures were extracted from wrist-worn GENEactiv devices; self-reported sleep measures using interview questions. RESULTS Linear mixed-effects regression analyses, with inclusion of a large number of confounders, show that self-reported sleep duration and actigraphy-based sleep duration and disturbance were associated with altered orthostatic heart rate response, particularly within the first 20 seconds poststanding. Self-reported short sleep (β = -0.06; 95% confidence interval [CI]: -0.11, -0.01) and long sleep (β = -0.15; 95% CI: -0.24, -0.05) and actigraphy-based short sleep (β = -0.08; 95% CI: -0.14, -0.01) were characterized by a smaller increase at 10 seconds (p < .01). Actigraphy-based short sleep (β = 0.15; 95% CI: 0.08, 0.22) and sleep disturbance (β = 0.04; 95% CI: 0.02, 0.06) were associated with a slower return toward baseline at 20 seconds (p < .001). CONCLUSIONS Our findings suggest sympathetic dysregulation, impaired vagal reactivation, and/or decreased baroreceptor sensitivity in the presence of shortened or disturbed sleep.
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Affiliation(s)
- Céline De Looze
- The Irish Longitudinal Study of Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Siobhan Scarlett
- The Irish Longitudinal Study of Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Louise Newman
- The Irish Longitudinal Study of Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study of Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland; Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin, Ireland
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Maasakkers CM, Thijssen DH, Knight SP, Newman L, O'Connor JD, Scarlett S, Carey D, Buckley A, McMorrow JP, Leidhin CN, Feeney J, Melis RJ, Kenny RA, Claassen JA, Looze CD. Hemodynamic and structural brain measures in high and low sedentary older adults. J Cereb Blood Flow Metab 2021; 41:2607-2616. [PMID: 33866848 PMCID: PMC8504407 DOI: 10.1177/0271678x211009382] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Due to its cardiovascular effects sedentary behaviour might impact cerebrovascular function in the long term, affecting cerebrovascular regulatory mechanisms and perfusion levels. Consequently this could underly potential structural brain abnormalities associated with cognitive decline. We therefore assessed the association between sedentary behaviour and brain measures of cerebrovascular perfusion and structural abnormalities in community-dwelling older adults. Using accelerometery (GENEActiv) data from The Irish Longitudinal Study on Ageing (TILDA) we categorised individuals by low- and high-sedentary behaviour (≤8 vs >8 hours/day). We examined prefrontal haemoglobin oxygenation levels using Near-Infrared Spectroscopy during rest and after an orthostatic challenge in 718 individuals (66 ± 8 years, 52% female). Global grey matter cerebral blood flow, total grey and white matter volume, total and subfield hippocampal volumes, cortical thickness, and white matter hyperintensities were measured using arterial spin labelling, T1, and FLAIR MRI in 86 individuals (72 ± 6 years, 55% female). While no differences in prefrontal or global cerebral hemodynamics were found between groups, high-sedentary individuals showed lower hippocampal volumes and increased white matter hyperintensities compared to their low-sedentary counterparts. Since these structural cerebral abnormalities are associated with cognitive decline and Alzheimer's disease, future work exploring the causal pathways underlying these differences is needed.
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Affiliation(s)
- Carlijn M Maasakkers
- Department of Geriatrics/Radboud Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Dick Hj Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.,Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Silvin P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Louise Newman
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - John D O'Connor
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Anne Buckley
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Jason P McMorrow
- The National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital, Dublin, Ireland
| | - Caoilfhionn Ní Leidhin
- The National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital, Dublin, Ireland
| | - Joanne Feeney
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - René Jf Melis
- Department of Geriatrics/Radboud Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Department of Medical Gerontology, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Jurgen Ahr Claassen
- Department of Geriatrics/Radboud Alzheimer Center, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Céline De Looze
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
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De Looze C, Feeney JC, Scarlett S, Hirst R, Knight SP, Carey D, Meaney JF, Kenny RA. Sleep duration, sleep problems and perceived stress are associated with hippocampal subfield volumes in later life: Findings from The Irish Longitudinal Study on Ageing (TILDA). Sleep 2021; 45:6374891. [PMID: 34558630 DOI: 10.1093/sleep/zsab241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
STUDY OBJECTIVES This study examines the cross-sectional and two-year follow-up relationships between sleep and stress and total hippocampal volume and hippocampal subfield volumes among older adults. METHODS 417 adults (aged 68.8±7.3; 54% women) from the Irish Longitudinal Study on Ageing completed an interview, a questionnaire and multiparametric brain MRI. The relationships between self-reported sleep duration, sleep problems, perceived stress and total hippocampal volume were examined by using ordinary least squares regressions. Linear mixed-effects models were used to investigate the relationships between sleep duration, sleep problems, perceived stress, changes in these measures over two-years and hippocampal subfield volumes. RESULTS No cross-sectional and follow-up associations between sleep and total hippocampal volume and between stress and total hippocampal volume were found. By contrast, Long sleep (≥9-10 hours / night) was associated with smaller volumes of molecular layer, hippocampal tail, presubiculum and subiculum. The co-occurrence of Short sleep (≤6 hours) and perceived stress was associated with smaller cornu ammonis 1, molecular layer, subiculum and tail. Sleep problems independently and in conjunction with higher stress, and increase in sleep problems over 2 years were associated with smaller volumes of these same subfields. CONCLUSION Our study highlights the importance of concurrently assessing sub-optimal sleep and stress for phenotyping individuals at risk of hippocampal subfield atrophy.
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Affiliation(s)
- Céline De Looze
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Joanne C Feeney
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Rebecca Hirst
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Silvin P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - James F Meaney
- The National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin, Ireland
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