Right hippocampal volume mediation of subjective memory complaints differs by hypertension status in healthy aging

Subjective memory complaints (SMCs) may be an important early indicator of cognitive aging and preclinical Alzheimer’s disease risk. This study investigated whether age-related differences in right or left hippocampal volume underlie SMCs, if these relationships differ by hypertension status, and how they are related to objective memory performance in a group of 190 healthy older adults, 50–89 years of age. Analyses revealed a significant mediation of the relationship between age and mild SMCs by right hippocampal volume that was moderated by hypertension status. This moderated mediation effect was not observed with left hippocampal volume. Additionally, a moderated serial mediation model showed that age predicted right hippocampal volume, which predicted SMCs, and in turn predicted objective memory performance on several measures of verbal selective reminding in individuals with hypertension, but not in non-hypertensives. Together, these findings suggest that even mild SMCs, in the context of hypertension, provide an early indicator of cognitive aging, reflecting a potential link among vascular risk, SMCs, and the preclinical risk for Alzheimer’s disease. •Age-related memory complaints in hypertensives are mediated by right hippocampal volume.•Mild memory concerns have a neuroanatomical basis leading to overt memory difficulties.•Mild memory complaints with hypertension may be an early marker of cognitive aging.•Aging with hypertension and memory concerns may lead to greater preclinical AD risk.