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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Published in:Journal of the American Geriatrics Society (JAGS) Vol. 55; no. 8; pp. 1161 - 1167
Main Authors: 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.
Format: Journal Article
Language:English
Published: Malden, USA Blackwell Publishing Inc 01.08.2007
Blackwell
Subjects:
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
Online Access:Get full text
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Summary: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.
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ISSN:0002-8614
1532-5415
DOI:10.1111/j.1532-5415.2007.01233.x