Cumulative blood pressure load and cognitive decline in older adults: An observational analysis of two large cohorts

Ying Xu^{1

2}, G Peggy McFall³, Lina Rydén⁴, Johan Skoog^{4

5}, Edward Chang⁶, Lucette A Cysique^{7

8}, Katie Harris^{1

9}, Sarah Kedwell¹, Mei Ling Lim^{1

10

11}, Kaarin J Anstey^{8

11

12}, Craig S Anderson^{1

9

13}, Roger A Dixon^{3

14}, Ingmar Skoog^{4

5}, Phillip J Tully¹⁵, Ruth Peters^{1

9}

Affiliations

¹ The George Institute for Global Health, Sydney, Australia.
² Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
³ Department of Psychology (Science), University of Alberta, Alberta, Canada.
⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden.
⁵ Region Västra Götaland, Sahlgrenska University Hospital, Neuropsychiatry Clinic, Gothenburg, Sweden.
⁶ University of Sydney Medical School, The University of Sydney, Sydney, Australia.
⁷ The Kirby Institute, Sydney, Australia.
⁸ School of Psychology, University of New South Wales, Sydney, Australia.
⁹ School of Biomedical Sciences, University of New South Wales, Sydney, Australia.
¹⁰ School of Population Health, University of New South Wales, Sydney, Australia.
¹¹ Neuroscience Research Australia, Sydney, Australia.
¹² Ageing Futures Institute, University of New South Wales, Sydney, Australia.
¹³ Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China.
¹⁴ Neuroscience and Mental Health Institute, University of Alberta, Alberta, Canada.
¹⁵ University of New England, Armidale, Australia.

PMID: 39811568
PMCID: PMC11730254
DOI: 10.1016/j.cccb.2024.100375

Cumulative blood pressure load and cognitive decline in older adults: An observational analysis of two large cohorts

Ying Xu et al. Cereb Circ Cogn Behav. 2024.

. 2024 Dec 16:8:100375.

doi: 10.1016/j.cccb.2024.100375. eCollection 2025.

Authors

Affiliations

¹ The George Institute for Global Health, Sydney, Australia.
² Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
³ Department of Psychology (Science), University of Alberta, Alberta, Canada.
⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden.
⁵ Region Västra Götaland, Sahlgrenska University Hospital, Neuropsychiatry Clinic, Gothenburg, Sweden.
⁶ University of Sydney Medical School, The University of Sydney, Sydney, Australia.
⁷ The Kirby Institute, Sydney, Australia.
⁸ School of Psychology, University of New South Wales, Sydney, Australia.
⁹ School of Biomedical Sciences, University of New South Wales, Sydney, Australia.
¹⁰ School of Population Health, University of New South Wales, Sydney, Australia.
¹¹ Neuroscience Research Australia, Sydney, Australia.
¹² Ageing Futures Institute, University of New South Wales, Sydney, Australia.
¹³ Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China.
¹⁴ Neuroscience and Mental Health Institute, University of Alberta, Alberta, Canada.
¹⁵ University of New England, Armidale, Australia.

PMID: 39811568
PMCID: PMC11730254
DOI: 10.1016/j.cccb.2024.100375

Abstract

Introduction: Cumulative blood pressure metrics may provide greater precision for measuring temporal risk exposure, especially in later life where data are mixed regarding associations of high blood pressure (BP) on cognitive function. We examined the relationship between greater cumulative exposure to high BP in later life and several domains of cognitive function.

Methods: Individual cognitive assessment scores and BP measurements in older adults (age ≥70 years) at baseline and over approximately 8 years of follow-up were available in the population-based Canadian Victoria Longitudinal Study (VLS) and Swedish Gothenburg H70 Birth Cohort Studies (H70). Linear mixed models were used to quantify associations between cumulative systolic and diastolic BP and change in cognitive scores.

Results: Each additional 100mmHg increase in cumulative BP was related to greater decline in the Rey Auditory Verbal Learning Test (RAVLT) List A, trials 1-5 total score over follow-up: -0.23 (95% confidence interval [CI] -0.32, -0.13) for systolic BP and -0.41 (95%CI -0.58, -0.23) for diastolic BP. Similarly increases cumulative systolic and diastolic BP were related to greater declines Digit Symbol Substitution Task (DSS) scores: -0.59 (95%CI -0.80, -0.38) and -1.04 (95% CI -1.40, -0.67), respectively. There were no associations of cumulative BP and temporal changes in general cognition, other measures of verbal episodic memory, or semantic fluency.

Conclusions: Higher cumulative BP is associated with greater declines in RAVLT measured immediate memory span and complex attention, information processing speed and visuospatial scanning in older adults, but the scale of change is small. Additional research is required to further define these relationships and identify opportunities for prevention.

Keywords: Blood pressure; Cognitive decline; Cohort; Old adults.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kaarin J Anstey declares a speaker fee from Roche (2023). The other authors have no competing interests to declare.

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Cumulative blood pressure load and cognitive decline in older adults: An observational analysis of two large cohorts

Affiliations

Cumulative blood pressure load and cognitive decline in older adults: An observational analysis of two large cohorts

Authors

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources