Relation of Blood Pressure to Risk of Incident Alzheimer’s Disease and Change in Global Cognitive Function in Older Persons

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
Neuroepidemiology (Impact Factor: 2.56). 02/2006; 26(1):30-6. DOI: 10.1159/000089235
Source: PubMed


To examine the relation of systolic and diastolic blood pressure to incident Alzheimer's disease (AD) and rate of cognitive change.
Longitudinal cohort study with annual clinical evaluations. At baseline, blood pressure was measured, apolipoprotein E (APOE) genotyping was performed, and medications were reviewed.
824 older Catholic clergy members without baseline dementia were recruited from across the United States. During a mean of about 6 years of observation, 151 persons developed AD. In a proportional hazards model adjusted for age, sex and education, neither systolic (relative risk = 0.995; 95% CI: 0.986, 1.004, p = 0.249) nor diastolic (relative risk = 1.000; 95% CI: 0.985, 1.015, p = 0.975) blood pressure was related to AD incidence. In mixed effects models, neither systolic nor diastolic blood pressure was related to level or to annual rate of change on a global measure of cognition. These results did not change in subsequent models that accounted for the use of medications with antihypertensive properties or for the possession of an APOE epsilon4 allele.
In a cohort of older persons with a majority taking medications with antihypertensive properties, we did not find a relationship between blood pressure and risk of AD or cognitive decline.

2 Reads
  • Source
    • "A diabetes study of the Japanese elderly reported that higher SBP at baseline is significantly associated with cognitive decline after 6 years (per 10 mm Hg increase, adjusted OR, 1.42) [35]. In contrast, a U.S. longitudinal cohort study of 824 older Catholic clergy (mean age, 75 years) reported that neither SBP nor DBP was related to AD incidence during a 6-year follow-up [37]. In the present study, SBP was associated with MCI in a logistic regression analysis, in concordance with some previous reports. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The aim of this study was to identify factors associated with mild cognitive impairment (MCI) in older Korean adults with type 2 diabetes mellitus. Methods A total of 226 older (age ≥65 years) adults without a history of cerebrovascular disease or dementia participated in this study. Cognitive function was assessed with the Montreal Cognitive Assessment-Korean version (MoCA-K). A MoCA-K score <23 was defined as MCI. Results The prevalence of MCI was 32.7%. In a logistic regression analysis, age (≥74 years old vs. 65-68 years old; odds ratio [OR], 3.69; 95% confidence interval [CI], 1.55 to 8.82; P=0.003), educational background (college graduation vs. no school or elementary school graduation; OR, 0.16; 95% CI, 0.05 to 0.46; P=0.001), and systolic blood pressure (≥135 mm Hg vs. ≤120 mm Hg; OR, 3.25; 95% CI, 1.29 to 8.17; P=0.012) were associated with MCI. Conclusion More concentrated efforts focused on early detection and appropriate management of MCI may be required in older Korean adults with type 2 diabetes mellitus.
    Full-text · Article · Apr 2014 · Diabetes & metabolism journal
  • [Show abstract] [Hide abstract]
    ABSTRACT: Until a few years ago, vascular risks were not considered to play a role in Alzheimer's disease; However recent studies on the epidemiology and pathogenesis of this disease now suggest a strong association between vascular risk factors linked to cerebrovascular disease and Alzheimer's disease. Furthermore,vascular factors in middle age have been suggested to increase the risk of late onset Alzheimer's disease. There is now growing evidence for the role of vascular factors in Alzheimer's disease and mixed dementia (Alzheimer's with cerebrovascular disease). The identification of vascular mechanisms contributing to dementia have helped to elucidate potential avenues for prevention or delaying its onset.
    No preview · Article · Jan 2007 · Research and Practice in Alzheimer's Disease
  • [Show abstract] [Hide abstract]
    ABSTRACT: Several studies report that blood pressure is increased in victims of Alzheimer's disease (AD) decades before the onset of the disease. Years before onset of Alzheimer's disease, blood pressure start to decrease and continues to decrease during the disease process. High blood pressure has also been related to pathological manifestations of Alzheimer's disease (senile plaques, neurofibrillary tangles, hippocampal atrophy). The exact mechanism behind these associations is not clear. Hypertension is also a risk factor for stroke, ischemic white matter lesions, silent infarcts, general atherosclerosis, myocardial infarction and cardiovascular diseases, and often clusters with other vascular risk factors, including diabetes mellitus, obesity and hypercholesterolemia. Also these risk factors have been related to Alzheimer's disease. Hypertension may thus cause cerebrovascular disease that may increase the possibility for individuals with AD encephalopathy to express a dementia syndrome. Hypertension may also lead to vessel wall changes in the brain, leading to hypoperfusion, ischemia and hypoxia which may initiate the pathological process of AD. Finally, subclinical AD may lead to increased blood pressure, and similar biological mechanisms may be involved in the pathogenesis of both disorders. Hypertension is a common disorder and often untreated. Several observational studies have reported that use of antihypertensives decreases risk of AD. Even though hypertension only results in a moderately increased risk of AD, or overall dementia, better treatment of hypertension may have an immense effect on the total number of demented individuals.
    No preview · Article · Oct 2006 · Neurological Research
Show more