TY - JOUR
T1 - Association Between Late-Life Blood Pressure and the Incidence of Cognitive Impairment
T2 - A Community-Based Prospective Cohort Study
AU - Yuan, Jin Qiu
AU - Lv, Yue Bin
AU - Chen, Hua Shuai
AU - Gao, Xiang
AU - Yin, Zhao Xue
AU - Wang, Wen Tao
AU - Kraus, Virginia Byers
AU - Luo, Jie Si
AU - Wang, Jiao Nan
AU - Zeng, Yi
AU - Mao, Chen
AU - Shi, Xiao Ming
N1 - Publisher Copyright:
© 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2019/2
Y1 - 2019/2
N2 - Objectives: To investigate the association between late-life blood pressure and the incidence of cognitive impairment in older adults. Design: Prospective cohort study. Setting: Community-living older adults from 22 provinces in China. Participants: We included 12,281 cognitively normal [Mini-Mental State Examination (MMSE) ≥ 24] older adults (median age: 81 years) from the Chinese Longitudinal Healthy Longevity Survey. Eligible participants must have baseline blood pressure data and have 1 or more follow-up cognitive assessments. Measurements: Baseline systolic (SBP) and diastolic blood pressure (DBP) were measured by trained internists. Cognitive function was evaluated by MMSE. We considered mild/moderate/severe cognitive impairment (MMSE <24, and MMSE decline ≥3) as the primary outcome. Results: The participants with hypertension had a significantly higher risk of mild/moderate/severe cognitive impairment (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.10-1.24). Overall, the associations with cognitive impairment seem to be hockey stick–shaped for SBP and linear for DBP, though the estimated effects for low SBP/DBP were less precise. High SBP was associated with a gradual increase in the risk of mild/moderate/severe cognitive impairment (P trend <.001). Compared with SBP 120 to 129 mmHg, the adjusted HR was 1.17 (95% CI 1.07-1.29) for SBP 130 to 139 mmHg, increased to 1.54 (95% CI 1.35-1.75) for SBP ≥180 mmHg. Analyses for high DBP showed the same increasing pattern, with an adjusted HR of 1.09 (95% CI 1.01-1.18) for DBP 90 to 99 mmHg and 1.19 (95% CI 1.02-1.38) for DBP ≥110 mmHg, as compared with DBP 70 to 79 mmHg. Conclusion: Late-life high blood pressure was independently associated with cognitive impairment in cognitively normal Chinese older adults. Prevention and management of high blood pressure may have substantial benefits for cognition among older adults in view of the high prevalence of hypertension in this rapidly growing population.
AB - Objectives: To investigate the association between late-life blood pressure and the incidence of cognitive impairment in older adults. Design: Prospective cohort study. Setting: Community-living older adults from 22 provinces in China. Participants: We included 12,281 cognitively normal [Mini-Mental State Examination (MMSE) ≥ 24] older adults (median age: 81 years) from the Chinese Longitudinal Healthy Longevity Survey. Eligible participants must have baseline blood pressure data and have 1 or more follow-up cognitive assessments. Measurements: Baseline systolic (SBP) and diastolic blood pressure (DBP) were measured by trained internists. Cognitive function was evaluated by MMSE. We considered mild/moderate/severe cognitive impairment (MMSE <24, and MMSE decline ≥3) as the primary outcome. Results: The participants with hypertension had a significantly higher risk of mild/moderate/severe cognitive impairment (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.10-1.24). Overall, the associations with cognitive impairment seem to be hockey stick–shaped for SBP and linear for DBP, though the estimated effects for low SBP/DBP were less precise. High SBP was associated with a gradual increase in the risk of mild/moderate/severe cognitive impairment (P trend <.001). Compared with SBP 120 to 129 mmHg, the adjusted HR was 1.17 (95% CI 1.07-1.29) for SBP 130 to 139 mmHg, increased to 1.54 (95% CI 1.35-1.75) for SBP ≥180 mmHg. Analyses for high DBP showed the same increasing pattern, with an adjusted HR of 1.09 (95% CI 1.01-1.18) for DBP 90 to 99 mmHg and 1.19 (95% CI 1.02-1.38) for DBP ≥110 mmHg, as compared with DBP 70 to 79 mmHg. Conclusion: Late-life high blood pressure was independently associated with cognitive impairment in cognitively normal Chinese older adults. Prevention and management of high blood pressure may have substantial benefits for cognition among older adults in view of the high prevalence of hypertension in this rapidly growing population.
UR - http://www.scopus.com/inward/record.url?scp=85049826798&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049826798&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2018.05.029
DO - 10.1016/j.jamda.2018.05.029
M3 - Article
C2 - 30017702
AN - SCOPUS:85049826798
SN - 1525-8610
VL - 20
SP - 177-182.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 2
ER -