[Show abstract][Hide abstract] ABSTRACT: Objective:
Higher selenium level has been hypothesized to have the potential to reduce the risk of cardiovascular diseases including dyslipidemia. However, results from previous studies are inconsistent. This study aims to determine the association between selenium level and dyslipidemia in elderly Chinese with relatively low selenium status.
A cross-sectional study of 1859 participants aged 65 or older from four rural counties in China was conducted. Serum total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDLC) and low-density lipoprotein-cholesterol (LDLC), nail selenium concentration and APOE genotype were measured in all subjects. The four types of dyslipidemia were defined as >5.17mmol/L for High-TC, >1.69 mmol/L for High-TG, >3.36 mmol/L for High-LDLC, and <1.04 mmol/L for Low-HDLC according to Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Logistic models adjusting for age, gender, APOE genotype, body mass index, alcohol consumption, smoking, physical activity, medication use for cardiovascular diseases were used to examine the relationship between selenium levels and the risk of dyslipidemia.
Mean nail selenium concentration was 0.465μg/gin this sample. Rates for High-TC, High-LDLC, High-TG, Low-HDLC were 18.13%, 13.23%, 12.21% and 32.76% respectively. Results from logistic models indicated that higher selenium levels were significantly associated with higher risk of High-TC, High-LDLC and lower risk of Low-HDLC adjusting for covariates (p < 0.0001). Compared with the lowest selenium quartile group, participants in selenium quartile groups 2, 3 and 4 had significantly higher rates of High-TC, High-LDLC, High-TG, and lower rate of Low-HDLC adjusting for covariates. No significant association was observed between selenium level and the risk of High-TG. APOEε4 carriers had higher rates of High-TC and High-LDLC. There was no interaction between selenium level and APOE with the rates of dyslipidemia.
Our results suggest long-term selenium exposure level may be associated with the risk of dyslipidemia in elderly population. Future studies are needed to examine the underlying mechanism of the association.
PLoS ONE 09/2015; 10(9):e0136706. DOI:10.1371/journal.pone.0136706 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Given the deleterious health effects associated with indoor air pollution (IAP), this study was conducted to evaluate an IAP intervention in rural areas in Gansu, one of the poorest provinces of China. We selected 371 rural households to take part in intervention measures including stove improvement and health education. Eight of 371 households were selected to conduct IAP sampling. Four hundred and thirteen women in these households completed a questionnaire and 49 women took part in lung function tests. After the intervention, PM 4 levels reduced from 455 μg/m 3 to 200 μg/m 3 and CO reduced from 3.40 ppm to 2.90 ppm in indoor air. The percentage of predicted value of FEV1 and FVC improved to some degree after the intervention, but all the parameters of lung function assessment did not show a significant change. Prevalence rates of several symptoms associated with IAP significantly declined in the study population, compared with base-line levels. Intervention measures combining stove improvement with health education were effective in reducing IAP levels. Women's health status, including eye and respiratory symptoms, also showed improvement. However, the effect on lung function was not apparent and warranted additional follow-up. Similarly, evaluation of the long term effects of the IAP intervention will require future studies.
Open Journal of Air Pollution 03/2015; 4(1):26-37. DOI:10.4236/ojap.2015.41004
[Show abstract][Hide abstract] ABSTRACT: To measure serum levels of heavy metals in Chinese pregnant women and their newborns, and to evaluate the association of these metals with infant birth weight.
We measured serum concentrations of lead (Pb), thallium (Tl), cadmium (Cd), selenium (Se), arsenic (As), nickle (Ni), vanadium (V), cobalt (Co), and mercury (Hg) in 81 mother-infant pairs using an inductively coupled plasma mass spectrometry method. Multiple linear regression analyses were used to evaluate the associations of these heavy metals with infant birth weight.
Se, Pb, As, and Cd showed the highest detection rates (98.8%) in both the maternal and cord blood, followed by Tl, which was detected in 79.0% and 71.6% of the maternal and cord blood samples, respectively. Pb had the highest concentrations in both the maternal and cord blood samples of all toxic metals detected, with concentrations of 23.1 ng/g and 22.0 ng/g, respectively. No significant associations were observed between any heavy metals and birth weight. However, Tl in the maternal and cord blood was most notably inversely associated with birth weight.
Se intake was low in Chinese women and their newborns, whereas Pb had the highest concentrations in both the maternal and cord blood samples of all toxic metals detected. Tl was a unique pollution source in this population, and Tl levels were shown to have the largest effect on decreasing infant birth weight in this pilot study. Further research incorporating larger sample sizes is needed to investigate the effects of prenatal exposure to heavy metals--especially Tl and Pb--on birth outcome in Chinese infants.
The Journal of reproductive medicine 03/2015; 60(1-2):21-9. · 0.70 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective:
A protective effect of selenium on lipid levels has been reported in populations with relatively low selenium status. However, recent studies found that high selenium exposure may lead to adverse cardiometabolic effects, particularly in selenium-replete populations. We examined the associations of selenium status with changes in lipid levels in a 7-year follow up of an elderly Chinese cohort including participants from selenium-deplete areas.
Study population consisted of 140 elderly Chinese aged 65 or older with nail selenium levels measured at baseline (2003-2005). Lipid concentrations were measured in fasting blood samples collected at baseline and the 7-year follow-up (2010-2012). Analysis of covariance (ANCOVA) models was used to determine the association between baseline selenium status and changes in lipid levels from baseline to follow-up adjusting for other covariates.
Mean (±standard deviation) baseline selenium concentration was 0.41±0.2mg/kg. In prospective analysis, we found that individuals in the highest selenium quartile group showed 1.11 SD decrease on total-cholesterol (p<0.001), 0.41 SD increase on HDL-cholesterol (p<0.001) and 0.52 SD decrease on triglyceride after 7 years than those in the lowest selenium quartile group. The similar trends were seen with significant lipid changes in the 2nd and 3rd quartile groups.
Selenium has modest beneficial effects on blood lipid levels in a population with relatively low selenium status. Our result suggests adequate dietary selenium intake as a potential prevention strategy for lowering lipid levels in selenium deplete populations.
Archives of Gerontology and Geriatrics 09/2014; 60(1). DOI:10.1016/j.archger.2014.09.005 · 1.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In utero exposure to organochlorine pesticides (OCPs) is thought to be potentially harmful to fetal development. We aimed to investigate the associations of maternal and cord serum OCPs levels with infant birth weight in China. In this study, we measured serum levels of 18 OCPs in 81 mother–infant pairs, including DDT, hexachlorocyclohexanes (BHC), hexachlorobenzene (HCB), heptachlors, chlordanes, endosulfan-I, and mirex using a high-resolution-gas-chromatography with high-resolution-mass-spectrometry method. We found that p,p′-DDE and β-BHC had the highest detection rate in both maternal and cord blood serum (97.2% and 96.7%, respectively), followed by HCB (93.0%, 51.7%), p,p′-DDT (88.7%, 36.7%), and p,p′-DDD (83.1%, 60.0%). Among all OCPs, the concentration of p,p′-DDE was the highest (mothers geometric mean (GM): 203.54 ng g−1, newborns GM: 116.14 ng g−1), followed by HCB (70.62 ng g−1, 65.16 ng g−1), and β-BHC (67.67 ng g−1, 33.39 ng g−1). Multiple linear regression analyses showed that each 1 ng g−1 increment of cord serum p,p′-DDE, total DDT, and β-BHC was associated with a 0.10 g, 0.10 g, and 0.92 g decrease in infant birth weight, respectively, and as the cord serum concentrations of p,p′-DDT, p,p′-DDD, HCB and mirex increased, the infant birth weight was also decreased, although the associations were not statistically significant due to the relatively small sample size. These results suggest that p,p′-DDE, β-BHC, and HCB were the predominant OCPs in the serum of Chinese pregnant women and cord blood of their newborns. Prenatal exposure to DDT, β-BHC, HCB, and mirex were associated with a decrease in birth weight, but these results need validation in larger sample-sized studies.
[Show abstract][Hide abstract] ABSTRACT: Background
Numerous studies have reported on the associations between ambient temperatures and mortality. However, few multi-city studies have been conducted in developing countries including China. This study aimed to examine the association between high temperature and mortality outcomes in four cities with different climatic characteristics in China to identify the most vulnerable population, detect the threshold temperatures, and provide scientific evidence for public health policy implementations to respond to challenges from extreme heat.
A semi-parametric generalized additive model (GAM) with a Poisson distribution was used to analyze the impacts of the daily maximum temperature over the threshold on mortality after controlling for covariates including time trends, day of the week (DOW), humidity, daily temperature range, and outdoor air pollution.
The temperature thresholds for all-cause mortality were 29°C, 35°C, 33°C and 34°C for Harbin, Nanjing, Shenzhen and Chongqing, respectively. After adjusting for potential confounders including air pollution, strong associations between daily maximum temperature and daily mortality from all-cause, cardiovascular, endocrine and metabolic outcomes, and particularly diabetes, were observed in different geographical cities, with increases of 3.2-5.5%, 4.6-7.5% and 12.5-31.9% (with 14.7-29.2% in diabetes), respectively, with each 1°C increment in the daily maximum temperature over the threshold. A stronger temperature-associated mortality was detected in females compared to males. Additionally, both the population over 55 years and younger adults aged 30 to 54 years reported significant heat-mortality associations.
Extreme heat is becoming a huge threat to public health and human welfare due to the strong temperature-mortality associations in China. Climate change with increasing temperatures may make the situation worse. Relevant public health strategies and an early extreme weather and health warning system should be developed and improved at an early stage to prevent and reduce the health risks due to extreme weather and climate change in China, given its huge population, diverse geographic distribution and unbalanced socioeconomic status with various climatic characteristics.
Environmental Health 08/2014; 13(1):65. DOI:10.1186/1476-069X-13-65 · 3.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Numerous studies have reported the association between ambient temperature and mortality. However, few studies have focused on the effects of extreme temperatures on diabetes mortality, particularly in China. The objective of the present study was to assess the effects of extremely cold and hot temperatures on diabetes mortality in urban areas of Harbin and Chongqing in China to provide scientific evidence for public health policy implementation to respond to challenges in diabetes mortality because of extreme temperature events.
A double threshold B-spline distributed lag non-linear model (DLNM) was used to investigate the effects of extremely cold and hot temperatures on diabetes mortality from lag 0 to 30 days, after controlling for potential confounders including air pollutants. The unit risk, which is the elevated cumulative risk of diabetes mortality caused by each 1 °C change in extremely cold and hot temperatures during certain lag days, was estimated for extreme cold and heat using simple regression analysis.
Significant associations between both extreme hot and cold temperatures and diabetes mortality were observed in Harbin and Chongqing for different lag lengths. In Harbin, the extreme cold effects on diabetes mortality were delayed by three days and lasted for six days (lag 3-8), with the highest risk (RR 95% CI: 1.223,1.054-1.418 for -23 °C) at lag 5. The hot effects were delayed one day and lasted for three days (lag 1-3), with the peak RR (1.343: 1.080-1.670 for 37 °C) at lag 2. In Chongqing, the cold effects on diabetes mortality were delayed by seven days and lasted for four days (lag 7-10), with the highest risk (1.201: 1.006-1.434 for 4 °C) at lag 7. The hot effects peaked (1.811: 1.083-3.027 for 41 °C) at lag 0 and lasted for 2 days (lag 0-1). The unit risk for cold and hot effects was 12.9% (95% CI: 2.5-33.7%) and 16.5% (95% CI: 3.8-39.1%) in Harbin and 12.5% (95% CI: -4.7 to 47.5%) and 19.7% (95% CI: 3.9-48.5%) in Chongqing, respectively.
The results indicate that both extremely cold and hot temperatures increase diabetes mortality in different manners in Harbin and Chongqing. Diabetes education programs should include information on either managing or combating the effects of extreme hot and cold weather.
Environmental Research 07/2014; 134C:91-97. DOI:10.1016/j.envres.2014.06.022 · 4.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction
Previous studies have identified hyperlipidemia as a potential risk factor for dementia and Alzheimer’s disease. However, studies on cholesterol measured in late-life and cognitive function have been inconsistent. Few studies have explored nonlinear relationships or considered interactions with other biomarker measures.
A cross-sectional sample of 1,889 participants from four rural counties in the People’s Republic of China was included in this analysis. Serum total cholesterol, high-density lipoprotein, triglycerides, and homocysteine levels were measured in fasting blood samples. A composite cognitive score was derived based on nine standardized cognitive test scores. Analysis of covariance models were used to investigate the association between biomarker measures and the composite cognitive scores.
There was a significant interaction between the homocysteine quartile group and the cholesterol quartile group on cognitive scores (P=0.0478). In participants with normal homocysteine levels, an inverse U-shaped relationship between total cholesterol level and cognitive score was found, indicating that both low and high cholesterol levels were associated with lower cognitive scores. In participants with high homocysteine levels, no significant association between cholesterol and cognition was found.
The relationship between cholesterol levels and cognitive function depends upon homocysteine levels, suggesting an interactive role between cholesterol and homocysteine on cognitive function in the elderly population. Additional research is required to confirm our findings in other populations, and to explore potential mechanisms underlying the lipid–homocysteine interaction.
[Show abstract][Hide abstract] ABSTRACT: Previous studies have shown that poor cognition and low body mass index were associated with increased mortality. But few studies have investigated the association between cognition and mortality across the entire cognitive spectrum while adjusting for BMI. The objective of this study is to examine the associations between cognitive function, BMI and 7-year mortality in a rural elderly Chinese cohort.
A prospective cohort of 2,000 Chinese age 65 and over from four rural counties in China were followed for 7-years. Cognitive function, BMI and other covariate information were obtained at baseline. Cox's proportional hazard models were used to determine the effects of cognitive function and BMI on mortality risk.
Of participants enrolled, 473 (23.7%) died during follow-up. Both lower cognitive function (HR = 1.48, p = 0.0049) and lower BMI (HR = 1.6, p < 0.0001) were independently associated with increased mortality risk compared to individuals with average cognitive function and normal weight. Higher cognitive function was associated with lower mortality risk (HR = 0.69, p = 0.0312). We found no significant difference in mortality risk between overweight/obese participants and those with normal weight.
Cognitive function and BMI were independent predictors of mortality risk. Intervention strategies for increasing cognitive function and maintaining adequate BMI may be important in reducing morality risk in the elderly population.
Archives of Public Health 03/2014; 72(1):9. DOI:10.1186/2049-3258-72-9
[Show abstract][Hide abstract] ABSTRACT: Organochlorine pesticides can interfere with the thyroid hormones that play an important role in early neurodevelopment. Although organochlorine pesticides have been banned in China since 1983, their residues are still detectable in the environment. However, few studies have investigated the adverse health effects of prenatal exposure to organochlorine pesticide residues on newborns in China. The present study, conducted in Yancheng City, Jiangsu Province, China, aimed to examine the association between the levels of organochlorine pesticides in maternal and cord sera and to assess the impact of prenatal exposure to organochlorine pesticides on thyroid hormone levels in cord serum. Eleven organochlorine pesticides in maternal and cord sera were measured in 247 mother–infant pairs recruited from Yancheng City between February 2010 and June 2010. The concentration of the thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH) were determined in cord serum. Among the 11 tested organochlorine pesticides, the detectable levels of hexachlorobenzene (HCB), β-hexachlorocycolohexane (β-HCH) and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) in both maternal and cord sera were above 50%. The levels of β-HCH and p,p'-DDE in maternal sera were positively associated with the levels in cord sera (r=0.421, P<0.01; r=0.288, P<0.01). After adjusting for confounders, the TSH level in cord serum samples was negatively associated with the HCB level (OR=0.535, 95% CI=(0.304–0.941)). Our data demonstrated that DDT, β-HCH and HCB residues bioconcentrate in maternal and cord sera. Moreover, the correlation analysis suggested that organochlorine pesticides in maternal blood can transfer through the placenta and affect newborn thyroid hormone levels.
Environmental Research 02/2014; 129:47–51. DOI:10.1016/j.envres.2013.12.009 · 4.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Studies concerning the effect of different types of leisure activities on various cognitive domains are limited. This study tests the hypothesis that mental, physical, and social activities have a domain-specific protection against cognitive decline.
A cohort of a geographically defined population in China was examined in 2003-2005 and followed for an average of 2.4 years. Leisure activities were assessed in 1,463 adults aged 65 years and older without cognitive or physical impairment at baseline, and their cognitive performances were tested at baseline and follow-up examinations.
High level of mental activity was related to less decline in global cognition (β = -.23, p < .01), language (β = -.11, p < .05), and executive function (β = -.13, p < .05) in ANCOVA models adjusting for age, gender, education, history of stroke, body mass index, Apolipoprotein E genotype, and baseline cognition. High level of physical activity was related to less decline in episodic memory (β = -.08, p < .05) and language (β = -.15, p < .01). High level of social activity was associated with less decline in global cognition (β = -.11, p < .05). Further, a dose-response pattern was observed: although participants who did not engage in any of the three activities experienced a significant global cognitive decline, those who engaged in any one of the activities maintained their cognition, and those who engaged in two or three activities improved their cognition. The same pattern was observed in men and in women.
Leisure activities in old age may protect against cognitive decline for both women and men, and different types of activities seem to benefit different cognitive domains.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 08/2012; 68(2). DOI:10.1093/gerona/gls153 · 5.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Selenium is considered a protective agent against free radicals through the maintenance of better enzyme activity. The few studies examining the relationship between selenium and depression have yielded inconsistent results and none of these studies considered the role of cognitive function in this context.
A cross-sectional evaluation of 1737 rural Chinese age 65 and over from two provinces in China was conducted. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Cognitive function was assessed using various cognitive instruments. Selenium measures were obtained from nail samples. Other information collected included demographic characteristics and medical history. Analysis of covariance models were used to identify factors associated with GDS score.
Higher selenium levels were associated with lower GDS scores adjusting for demographic and medical conditions (p = 0.0321). However, the association between selenium and depressive symptoms was no longer significant when cognitive function score was adjusted in the model (p = 0.2143).
Higher selenium level was associated with lower depressive symptoms without adjusting for cognition in this cohort. However, after cognition was adjusted in the model the association between selenium and depressive symptoms was no longer significant, suggesting that selenium's association with depressive symptoms may be primarily through its association with cognitive function.
[Show abstract][Hide abstract] ABSTRACT: Normative information is important for appropriate interpretation of cognitive test scores as a critical component of dementia diagnosis in the elderly population. A cross-sectional evaluation of 1826 participants aged 65 years and older from four rural counties in China was conducted using six cognitive instruments including tests of global cognitive function (the Community Screening Instrument for Dementia), memory (Word List Learning and Recall tasks from the Consortium to Establish a Registry for Alzheimer's Disease, IU Story), language (Animal Fluency Test), and executive function (IU Token). Multiple regression models adjusting for demographic variables were used to provide standardized residuals z-scores and corresponding percentile ranking for each cognitive test. In all cognitive tests older age was associated with worse test performance while exposure to education was related to better cognitive test performance. We also detected a significant gender difference with men scoring better than women and a significant gender by education interaction on two tests. The interaction indicates that gender difference in test scores was much smaller in participants with more education than those who had less or no education. These demographically adjusted, regression-based norms can be a useful tool to clinicians involved with differential diagnosis of cognitive and memory disorders in older adults in rural China.
The Clinical Neuropsychologist 03/2012; 26(4):641-53. DOI:10.1080/13854046.2012.666266 · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To develop a method for determining 11 kinds of phthalate metabolites in urine simultaneously.
The phthalate metabolites in human urine samples were hydrolyzed by glucuronidase, and then were concentrated by solid-phase extraction and eluted by methanol/acetonitrile (1 : 1, V/V). After chromatographic separation on phenyl column, the analytes were analyzed qualitatively and quantitatively under MRM mode.
The limits of detection (LOD) for the eleven kinds of phthalate metabolites were in the range of 0.13 - 2.27 ng/ml. The mean recoveries at the two spiked levels were 67% - 108%, with the relative standard deviation (RSD) of less than 12%.
The method can be used to determine the residues of eleven kinds of phthalate metabolites in urine accurately and sensitively.
Wei sheng yan jiu = Journal of hygiene research 01/2012; 41(1):109-12.
[Show abstract][Hide abstract] ABSTRACT: To investigate the relationship between environmental risk factors and respiratory and eye symptoms of women in rural areas, so as to provide baseline data for the intervention of indoor air pollution.
A household survey on the environmental risk factors and the health of 1575 rural women was analyzed.
After age and income being adjusted, the OR of smoking, passive smoking, no ventilation indoors, using both coal and biomass versus respiratory symptoms were 2.42, 1.35, 1.52 and 1.44. The OR of cooking years and the age of beginning to cook versus respiratory symptoms were 1.44 and 0.92. The OR of no ventilation indoors, using both coal and biomass versus eye symptoms were 1.67 and 1.49. The OR of cooking years and the age of beginning to cook versus eye symptoms were 1.56 and 0.92. The OR of increasing cooking time everyday versus eye symptoms was 1.36.
Exposure to indoor air pollution during cooking time was the most significant environmental risk factor for the respiratory and eye symptoms in rural women.
Wei sheng yan jiu = Journal of hygiene research 05/2011; 40(3):345-7.
[Show abstract][Hide abstract] ABSTRACT: To know the relationship between selenium exposure level and cognitive function and its influencing factors in rural elderly people.
A cross-sectional survey of 200 local rural elderly people were conducted by using dietary questionnaire and six cognitive questionnaires. The local environment samples were collected including food and nail and blood sample of study individuals. The trace amount of selenium were determined with 2, 3-diaminonaphthalenet fluorometric determination. Multiple stepwise regression was used to examine the association between selenium exposure level and the composite Z score adjusting for age, gender, education, and other factors that might influence the cognitive scores.
There were significant positively relationships between three selenium exposure indexes. The results showed that food selenium intake level and blood selenium level could significantly affected the Z score after adjusting age, education and other factors by using multiple stepwise regression analysis (P < 0.001).
Lower selenium exposure level maybe associated with lower cognitive function in rural elderly people.
Wei sheng yan jiu = Journal of hygiene research 07/2010; 39(4):483-5, 490.
[Show abstract][Hide abstract] ABSTRACT: Late life depression has been studied in many populations around the world. However, findings on risk factors for late life depression have remained inconsistent.
A cross-sectional survey of 1737 rural Chinese age 65 and over from two provinces in China was conducted assessing cognitive functions using various cognitive instruments and collecting information on demographic characteristics and medical history. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Analysis of covariance and logistic regression models were used to identify factors associated with the continuous GDS score, mild or severe depression.
In this cohort, 26.5% (95% CI: 24.4-28.6%) met the criteria for mild depression and 4.3% (95% CI: 3.4-5.4%) for severely depression. Living alone, history of heart attack, head injury, and fracture were associated with higher depressive symptoms. Alcohol consumption and higher cognitive function were associated with lower depressive symptoms. Living alone, not attended school, history of head injury, fracture, and low cognitive function were associated with increased probability of mild depression. Living alone, history of stroke or heart attack, and low cognitive function were associated with severe depression.
Depression, particularly mild depression, is common in rural elderly Chinese. Among a number of factors identified in this cohort as being significantly associated with depressive symptoms, living alone and lower cognitive function were the most consistent factors associated with depressive symptoms, mild and severe depression. History of stroke, heart attack, and fracture were also risk factors for depressive symptoms.
International Journal of Geriatric Psychiatry 12/2009; 24(12):1358-66. DOI:10.1002/gps.2271 · 2.87 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To examine the association between hypertension and cognitive decline in older adults.
Prospective observational study.
Four rural counties in China.
Two thousand rural Chinese aged 65 and older (median age 70, range 65-92) participated in a baseline evaluation. A follow-up evaluation of 1,737 subjects was conducted 2.5 years after baseline.
Cognitive function was assessed using the Community Screening Instrument for Dementia (CSID), Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning and Recall Tests, Indiana University (IU) Story Recall Test, Animal Fluency Test, and IU Token Test. Hypertension was defined as the mean of two readings of systolic blood pressure (BP) of 140 mmHg or greater, diastolic BP of 90 mmHg or greater, or according to self-report. Cognitive decline was derived as the difference between baseline and follow-up scores. Analysis of covariance models were used to estimate the association between hypertension, BP, and cognitive decline, adjusting for other covariates.
Greater decline was found on the CERAD 10-Word List Learning (P<.001) and Recall (P=.01) scores for subjects with hypertension than for those without. In particular, significantly greater decline was seen in the group with hypertension that was not taking medication than in the group without hypertension. No significant difference on cognitive decline was found between subjects with hypertension who were taking medication and those without hypertension.
Untreated hypertension was associated with greater cognitive decline in this Chinese cohort. Better hypertension detection and treatment in elderly people, especially in developing countries, may offer protection against cognitive decline.
Journal of the American Geriatrics Society 06/2009; 57(6):1051-7. DOI:10.1111/j.1532-5415.2009.02267.x · 4.57 Impact Factor