Association Between Late-Life Blood Pressure and the Incidence of Cognitive Impairment: A Community-Based Prospective Cohort Study

Yuan, Jingya; Lv, Yue; Chen, Hua Shuai; Gao, Xiang; Yin, Zhaoxue; Wang, Wen Tao; Kraus, Virginia B.; Luo, Jie; Wang, Jiao Nan; Zeng, Yi; Chen, Mao; Shi, Xiao Ming

doi:10.1016/j.jamda.2018.05.029

Cited by 31 publications

(24 citation statements)

References 31 publications

(47 reference statements)

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“…Some researchers found that the increased risk of dementia was related to the increase of SBP in the group under 75 years old [17]. The risk of cognitive impairment increased by 1.17 times when SBP was 130-139 mmHg, however, it increased to 1.54 times when SBP was≥180 mmHg [16]. The results of 3.8-year follow-up of hypertension (n=2800) showed that incidences of MCI and dementia could decrease by 15% in intensive control of blood pressure (SBP<120 mmHg) compared with the standard control group (SB<140 mmHg) (HR = 0.85, 95% CI = 0.74-0.97, P = 0.02) [31]; moreover, statistically significant reduced risk of MCI and dementia can be found in the intensive group (SBP =120 mmHg) less than 75 years old [32].…”

Section: Discussionmentioning

confidence: 99%

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Later Onset of Hypertension Is Associated with Higher Risk of Dementia in Mild Cognitive Impairment

Qin

Wang

et al. 2019

Preprint

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ObjectiveTo investigate the correlation between hypertension development and the progression of MCI for middle aged and elderly people. MethodsA population-based longitudinal cognition survey of people aged 55+ was conducted. The hypertension onset age was estimated by self-reported information and medical insurance card records. In order to study the effect of later onset of hypertension on dementia, the incidence of dementia was compared between the two groups. ResultsA total of 277 hypertensive mild cognitive impairment (MCI) participants without dementia were followed for 6 years. Overall, 56 MCI participants (20.22%) progressed to dementia (MCIp). The proportion of MCIp participants in the old-age onset hypertension group (≥ 65 years) was higher than that of middle-age onset one (27.0% vs 15.4%; X2 = 5.538, P = 0.019). And in the old-age onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7% vs 12.6%; X2 = 5.321, P = 0.021), and the proportion of MCIp with increased pulse pressure was higher than those without increased pulse pressure (33.3% vs 15.4%; X2 = 3.902, P = 0.048). However, the multivariate logistic regression analysis showed that older age was the only risk for MCIp (OR=0.732, p=0.029). ConclusionsThese results suggest that, individuals with later onset hypertension may have greater cognition decline, even in cases with blood pressure maintained at 130/80 mmHg with antihypertensive management.

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Section: Discussionmentioning

confidence: 99%

“…For example, some studies have found that hypertension is independently associated with cognitive impairment in later life, the cognitive function declining with increasing SBP, especially SBP ≥ 180mmHg [13][14][15]. In Yuan's study, the cognition declined with the increased SBP like a hockey [16].…”

mentioning

confidence: 99%

Later Onset of Hypertension Is Associated with Higher Risk of Dementia in Mild Cognitive Impairment

Qin

Wang

et al. 2019

Preprint

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“…Some researchers found that the increased risk of dementia was related to the increase of SBP in the group under 75 years old [17]. The risk of cognitive impairment increased by 1.17 times when SBP was 130-139 mmHg, however, it increased to 1.54 times when SBP was≥180 mmHg [16]. The results of 3.8-year follow-up of hypertension (n = 2800) showed that incidences of MCI and dementia could decrease by 15% in intensive control of blood pressure (SBP<120 mmHg) compared with the standard control group (SB<140 mmHg) (HR = 0.85, 95% CI = 0.74-0.97, P = 0.02) [31]; moreover, statistically significant reduced risk of MCI and dementia can be found in the intensive group (SBP = 120 mmHg) less than 75 years old [32].…”

Section: Discussionmentioning

confidence: 99%

Later onset of hypertension increased the risk of dementia in Mild Cognitive Impairment in community

Qin

Zhao

et al. 2019

Preprint

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Objective To investigate the effect of later onset of hypertension on the progression of MCI in community. Methods Participants are from The Study (NO.PKJ2010-Y26, 2011), a population-based longitudinal cognition survey of people aged 55+, sampled by probability proportional to size cluster. Hypertension onset age was estimated by self-reported information and medical insurance card records, then classified into two groups: the middle-age group (onset age < 65 years) and the old-age group (onset age ≥ 65 years). In order to study the effect of later onset of hypertension on dementia, the incidence of dementia was compared between the two groups. Results A total of 277 hypertensive mild cognitive impairment (MCI) participants without dementia were followed for 6 years. 56 MCI participants (20.22%) progressed to dementia (MCIp). The proportion of MCIp participants in the old-age onset hypertension group (≥ 65 years) was higher than that of middle-age onset one (27.0% vs 15.4%; X2 = 5.538, P = 0.019). And in the old-age onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7% vs 12.6%; X2 = 5.321, P = 0.021), and the proportion of MCIp with increased pulse pressure was higher than those without increased pulse pressure (33.3% vs 15.4%; X2 = 3.902, P = 0.048). However, the multivariate logistic regression analysis showed that older age was the only risk for MCIp (OR=0.732, p=0.029). Conclusions These results suggest that, later onset hypertension was harmful to cognition even in cases where the level of blood pressure maintained at 130/80mmHg with antihypertensive management. It is necessary to expand the research sample and improve the experimental methods for further confirmation.

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“…The total MMSE score ranges from 0 to 30 within 6 dimensions: orientation, registration, attention, language, memory, and visual construction skills. Three methods were used to define cognitive impairment: (1) ≥24, 18-23, and < 18 were used to define normal cognition (reference), mild cognitive impairment and serious cognitive impairment [22,23]; (2) < 18 was used to define cognitive impairment for participants who didn't receive any formal education, < 21 for participants who received 6 years of education or less, and < 25 for participants who received more than 6 years of education [16,24]; (3)≥24 and < 23 were used to define normal cognition (reference) and cognitive impairment [22,23].…”

Section: Assessment Of Cognitive Impairment and Mortalitymentioning

confidence: 99%

Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China

Duan

Gao

et al. 2020

BMC Geriatr

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Background: Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluated by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and further explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China. Methods: A total of 13,906 and 13,873 Chinese elderly aged 65 years and older were included in the 2002-2008 and 2008-2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cutoffs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality.

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Association Between Late-Life Blood Pressure and the Incidence of Cognitive Impairment: A Community-Based Prospective Cohort Study

Cited by 31 publications

References 31 publications

Later Onset of Hypertension Is Associated with Higher Risk of Dementia in Mild Cognitive Impairment

Later Onset of Hypertension Is Associated with Higher Risk of Dementia in Mild Cognitive Impairment

Later onset of hypertension increased the risk of dementia in Mild Cognitive Impairment in community

Association of cognitive impairment and elderly mortality: differences between two cohorts ascertained 6-years apart in China

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