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Blood pressure and cognitive decline over the course of 2 years in elderly people: a community-based prospective cohort study

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Abstract

Background

Numerous studies have shown a significant association between blood pressure (BP) and cognition, but little is known about the effect of BP on the rate of cognitive decline.

Aims

To investigate the relationship between blood pressure and the subsequent rate of cognitive decline in elderly people.

Methods

Based on a prospective cohort that has been followed since 2014, we collected baseline blood pressures and other covariates in 7874 Chinese individuals aged 60 years or older, and followed their cognitive change using the Mini-Mental State Examination (MMSE) until Dec 31, 2016. Linear mixed-effects models were used to measure changes in MMSE scores over time in relation to blood pressure values, and in addition to the covariates, we included random effects for intercepts and slopes.

Results

In the non-hypertension group, we observed that faster cognitive decline was associated with higher systolic blood pressure, lower diastolic blood pressure, lower mean arterial pressure, and higher pulse pressure. In the hypertension group, lower diastolic blood pressure, lower mean arterial pressure, and higher pulse pressure were associated with faster cognitive decline, but not systolic blood pressure.

Conclusion

Higher systolic blood pressure, lower diastolic blood pressure, lower mean arterial pressure, and higher pulse pressure accelerate the subsequent rate of cognitive decline in elderly people. The results of this study may help improve blood-pressure control strategies to prevent cognitive decline.

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Availability of data and materials

The data that support the findings of this study are available from the ethics committee of Zhejiang Provincial Center for Disease Control and Prevention but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of the ethics committee of Zhejiang Provincial Center for Disease Control and Prevention.

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Acknowledgements

We acknowledge the invaluable contributions made by all the interviewers in this study. We would also like to express our gratitude to all the participants.

Funding

Fudong Li was supported by Natural Science Foundation of Zhejiang Province (Q19H260001), and Fan He was supported by Zhejiang Provincial Public Welfare Technology Application Research Foundation (LGF19H260003).

Author information

Author notes

  1. Tao Zhang, Fan He and Jianjiang Hu contributed equally to this work.

Authors and Affiliations

  1. Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399, Binsheng Rd., Binjiang District, Hangzhou, Zhejiang, People’s Republic of China

    Tao Zhang, Fan He, **nyi Wang, Fudong Li, Yujia Zhai, Xue Gu, Mengna Wu & Junfen Lin

  2. Office, Binjiang Center for Disease Control and Prevention, Hangzhou, Zhejiang, China

    Jianjiang Hu

Authors
  1. Tao Zhang
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  2. Fan He
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Contributions

TZ, FH, JH, JL, XW, FL, YZ, XG, and MW participated in the design of the study, collection of data, data cleaning. TZ and FH conducted the statistical analyses. TZ wrote the manuscript. JH, FH, and JL contributed to the interpretation of the results and revised the manuscript critically. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Junfen Lin.

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Conflict of interest

The authors declare no competing interests.

Statement of human and animal rights

The study was approved by the ethics committee of Zhejiang Provincial Center for Disease Control and Prevention.

Informed consent

Informed consent was obtained from each participant or their legally authorized representative (low literacy and/or physically disabled participants).

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Zhang, T., He, F., Hu, J. et al. Blood pressure and cognitive decline over the course of 2 years in elderly people: a community-based prospective cohort study. Aging Clin Exp Res 33, 1903–1908 (2021). https://doi.org/10.1007/s40520-020-01717-7

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  • DOI: https://doi.org/10.1007/s40520-020-01717-7

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