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. 2004 Nov;59(11):1191-4.
doi: 10.1093/gerona/59.11.1191.

Effect of blood pressure on cognitive functions in elderly persons

Hsu-Ko Kuo  1 , Farzaneh Sorond, Ikechukwu Iloputaife, Margaret Gagnon, William Milberg, Lewis A Lipsitz
Affiliations

Effect of blood pressure on cognitive functions in elderly persons

Hsu-Ko Kuo et al. J Gerontol A Biol Sci Med Sci. 2004 Nov.

Abstract

Background: Little is known about what specific cognitive functions are affected by elevated blood pressure (BP) and how orthostatic BP change is related to cognitive impairment. The aim of this study was to determine the effect of BP and its postural change on cognitive functions in otherwise healthy elders.

Methods: In 70 healthy persons (mean age, 72 +/- 4 years), supine systolic BP (SBP) was assessed 3 times using a sphygmomanometer, and the average values were obtained for the analysis. After 1, 3, and 5 minutes of standing, 3 BP measurements were obtained and the orthostatic SBP changes were determined by subtracting these values from the supine average. Neuropsychological tests were administered to assess short-term and long-term verbal and visual memory, visuospatial skills, and frontal-executive functions. Participants were considered impaired in the specific cognitive performance if their scores fell below the 25th percentile of the study population. Multiple logistic regression models were used to evaluate the relation of SBP and the magnitude of orthostatic SBP decline to risk for impairment in each of the cognitive tests.

Results: Controlling for potential confounders, each 10 mmHg increase in supine SBP was associated with a 2.31-fold increase (95% confidence interval, 1.14 to 4.66) in risk for impairment in psychomotor speed and set shifting as measured using the Trailmaking Part-B test. There was no significant association between cognitive functions and orthostatic SBP decline at 1, 3, and 5 minutes of standing.

Conclusion: Elevation of BP is associated with a selective impairment in executive function in otherwise healthy community-dwelling elders.

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Figures

Figure 1
Figure 1
The relationship between supine systolic blood pressure (SBP) quartiles and the risk for Trailmaking Part-B test performance below the 25th percentile. Participants with the lowest quartile of supine SBP were the reference group. Participants whose supine SBP measurements were in the third quartile and the highest quartile had nearly 4-fold and 9-fold risks for impairment in the Trailmaking Part-B test compared with the reference group. Participants whose supine SBPs were in the second quartile showed a similar risk compared with the reference group.
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