Effects of age and hypertension status on cognition: the Veterans Affairs Normative Aging Study.
ABSTRACT The authors examined the influence of age and hypertensive status (normotensive, controlled, untreated, or uncontrolled) on several cognitive tests via multiple regression in 357 nondemented, community-dwelling older men (mean age=67 years) whose hypertensive status was stable over 3 years and who had no medical comorbidities. Age was negatively associated with performance on all but 1 test. Age interacted with hypertensive status on verbal fluency and word list immediate recall; older uncontrolled hypertensives exhibited significantly larger age decrements on these tests compared with normotensives. These findings suggest that uncontrolled hypertension produces specific cognitive deficits beyond those attributable to age alone. These and previous findings illustrate that health conditions such as hypertension should be regularly considered in studies of "normal" cognitive aging.
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ABSTRACT: To determine the extent to which individual changes in systolic blood pressure (SBP) over a 30-year interval are associated with differential neuropsychological outcomes in old age. Seven hundred seventeen survivors from the Western Collaborative Group Study, a longitudinal study of cardiovascular risk factors now in its 38th year of follow-up, with blood pressures measured in middle age (mean=45 years) and in old age (mean=75 years) and neuropsychological tests administered at follow-up were included in this analysis. Participants were grouped according to 30-year change in SBP (increased, decreased, or "normal"). Analyses focused on comparisons of neuropsychological performance of "high SBP trackers" (ie, those with persistent SBP>/=140 mm Hg throughout adult life) and of SBP "decreasers" with the performance of those whose SBP was either stable or changed in an expected way over time. Only 7.5% of participants had elevated SBP in middle age, but 43.8% of participants had elevated SBP in old age. After adjustment for age, education, depression, clinically defined stroke, and use of antihypertensive medications and after exclusion of individuals with impaired cognitive performance at follow-up, high SBP trackers, 5.0% (n=36), performed consistently less well than the "normal" SBP subgroups on a composite measure of verbal learning and memory (P=0.04). When compared with the "normal" SBP subgroup, the SBP decreasers, 5.3% (n=38), performed less well on speeded performance (P=0.03). There is a relatively small group of people who maintain elevated SBP throughout their adult lives. These persons are at increased risk for reduced verbal learning and memory function. There is also a group of individuals who experience a decrease in SBP and who are at risk for decreased psychomotor speed. Delineation of these 2 SBP subgroups may lead to further clarification of the effects of SBP on neurobehavioral function in older adults.Stroke 11/1998; 29(11):2334-40. · 6.16 Impact Factor
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ABSTRACT: Previous research suggests that some aspects of cognitive performance decline as a joint function of age and hypertension. In this experiment, 51 unmedicated individuals with mild essential hypertension and 48 normotensive individuals, 18-78 years of age, performed a visual search task. The estimated time required to identify a display character and shift attention between display positions increased with age. This attention shift time did not differ significantly between hypertensive and normotensive participants, but regression analyses indicated some mediation of the age effect by blood pressure. For individuals less than 60 years of age, the error rate was greater for hypertensive than for normotensive participants. Although the present design could detect effects of only moderate to large size, the results suggest that effects of hypertension may be more evident in a relatively general measure of performance (mean error rate) than in the speed of shifting visual attention.Health Psychology 02/1998; 17(1):76-83. · 3.83 Impact Factor
- Neuroepidemiology 02/1997; 16(4):163-73. · 2.37 Impact Factor