Blood Pressure and All‐Cause Mortality by Level of Cognitive Function in the Elderly: Results From a Population‐Based Study in Rural Greece

Abstract

7This study aimed to investigate whether the effect of blood pressure (BP) on mortality differs by levels of cognitive function. The associations of brachial systolic BP, diastolic BP, mean arterial pressure (MAP), and pulse pressure with all-cause mortality were prospectively explored (follow-up 7.0AE2.2 years) in 660 community-dwelling individuals (≥60 years) using adjusted Cox models, stratified by cognitive impairment (Mini-Mental State Examination [MMSE] <24). No association between brachial BP variables and mortality was shown for the total sample in quartiles analysis; however, MAP in the highest quartile, compared with the second, was associated with mortality (hazard ratio, 1.85; 95% confidence intervals, 1.09-3.12) among cognitively impaired individuals. The fractional-polynomials approach for BP confirmed this finding and further showed, solely in the MMSE <24 subcohort, U-shaped trends of MAP and systolic BP, with increased mortality risk in extremely low or high values; no such pattern was evident for patients with MMSE ≥24. Elderly individuals with cognitive impairment might be more susceptible to the detrimental effects of low and elevated MAP and systolic BP.

Cognitive Function and Mortality: Results from Kaunas HAPIEE Study 2006–2017

“…This reduces bias by controlling socio-demographic, psychological, and biological CVD risk factors. Previous studies noted that, in the analysis of cognitive function and mortality association, various covariates should be controlled, such as physical and mental health factors as well as psychosocial [37] and cerebrovascular risk factors [39][40][41]. We assessed the various components of cognitive function, such as immediate and delayed memory, attention and cognitive speed, and not only the composite score as usual.…”

Association of cognitive impairment and grip strength trajectories with mortality among middle-aged and elderly adults

“…First, it is likely that a cognitive impairment associated with progression from preclinical to established vascular dementia is a marker for cerebrovascular disease that were the strongest predictors of stroke and cerebrovascular death (Elkins et al, 2005;Laukka et al, 2004;Wiberg et al, 2010). Second, elderly people with cognitive impairment might be more susceptible to the detrimental effects of low and elevated mean arterial pressure (MAP) and systolic blood pressure (SBP) (Georgakis et al, 2017;Weidung et al, 2016). It is possible that increased vulnerability of patients with cognitive impairment to the detrimental effects of low and high SBP and MAP is mediated by the underlying cardiovascular disease (CVD) burden.…”

A Conceptual Model for Pricing Health and Life Insurance Using Wearable Technology

“…Elevated resting heart rate has been shown by many studies to be an independent predictor of both cardiovascular and all-cause mortality (Seccareccia et al, 2001;Jensen et al, 2013;Zhang et al, 2015). This is not the only possible metric however; blood pressure is shown to be strongly associated with the occurrence of a stroke, and is also highly correlated to all-cause mortality (Georgakis et al, 2017). As technology progresses heart rate variability, which is typically measured by ECG, will likely become measurable on a continuous basis and shows much promise in being used to predict heart failure (Lucena et al, 2016).…”