Age-Varying Association Between Blood Pressure and Risk of Dementia in Those Aged 65 and Older: A Community-Based Prospective Cohort Study

OBJECTIVES: To assess variation in the association between blood pressure (BP) and risk for dementia across a spectrum of older ages and to examine BP changes before dementia onset. DESIGN: Prospective cohort study. SETTING: A large health maintenance organization in Seattle, Washington. PARTICIPANT...

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Vydáno v:	Journal of the American Geriatrics Society (JAGS) Ročník 55; číslo 8; s. 1161 - 1167
Hlavní autoři:	Li, Ge, Rhew, Isaac C., Shofer, Jane B., Kukull, Walter A., Breitner, John C. S., Peskind, Elaine, Bowen, James D., McCormick, Wayne, Teri, Linda, Crane, Paul K., Larson, Eric B.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Malden, USA Blackwell Publishing Inc 01.08.2007 Blackwell
Témata:	Age Factors Aged Aged, 80 and over Alzheimer's disease Biological and medical sciences blood pressure Blood Pressure - physiology Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases dementia Dementia - epidemiology Dementia - etiology Female General aspects Humans hypertension Hypertension - complications Male Medical sciences Miscellaneous Neurology Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors INE, USA, Washington, Seattle Alzheimer disease Cardiovascular disease Risk Association Cohort study Arterial pressure Degenerative disease Blood pressure Alzheimer's disease Age Public health Human Hypertension Nervous system diseases Cerebral disorder Senile dementia Gerontology Follow up study Central nervous system disease Risk factor dementia Hemodynamics Elderly Community Geriatrics
ISSN:	0002-8614, 1532-5415
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Shrnutí:	OBJECTIVES: To assess variation in the association between blood pressure (BP) and risk for dementia across a spectrum of older ages and to examine BP changes before dementia onset. DESIGN: Prospective cohort study. SETTING: A large health maintenance organization in Seattle, Washington. PARTICIPANTS: A cohort of 2,356 members of a large health maintenance organization aged 65 and older who were initially without dementia. MEASUREMENTS: Dementia diagnosis was assessed biennially, and systolic (SBP) and diastolic BP (DBP) were measured at baseline and at four follow‐up assessments. Cox proportional hazards models were used to estimate hazard ratios (HRs) for dementia and Alzheimer's disease (AD) associated with baseline BP in different age groups. RESULTS: Within the youngest age group (65–74 at enrollment) a greater risk for dementia was found in participants with high SBP (≥160 mmHg) (hazard ratio (HR)=1.60, 95% confidence interval (CI)=1.01–2.55) or borderline‐high DBP (80–89 mmHg) (HR=1.59, 95% CI=1.07–2.35) than for those with normal BP (SBP <140 mmHg and DBP <80 mmHg). The dementia risk associated with SBP declined with increasing age (SBP‐by‐age interaction, P=.01). SBP declined similarly with aging in subjects who developed dementia and those who did not. Thus, in this sample, the association between SBP and dementia risk was not dependent on when BP was measured in relation to onset of dementia. CONCLUSION: High SBP was associated with greater risk of dementia in the young elderly (<75) but not in older subjects. Adequate control of hypertension in early old age may reduce the risk for dementia.
Bibliografie:	ArticleID:JGS1233 ark:/67375/WNG-S44XQ61S-C istex:8AF56792C8818F0BA92EBC82D08EBB8156D4F689 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-8614 1532-5415
DOI:	10.1111/j.1532-5415.2007.01233.x