Lv, Y-B, Zhu, P-F, Yin, Z-X et al. (11 more authors) (2017) A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly. Journal of the American Medical Directors Association, 18 (2). 193.e7-193.e13. ISSN 1525-8610
Abstract
Objectives
Higher or lower blood pressure may relate to cognitive impairment, whereas the relationship between blood pressure and cognitive impairment among the elderly is not well-studied. The study objective was to determine whether blood pressure is associated with cognitive impairment in the elderly, and, if so, to accurately describe the association.
Design
Cross-sectional data from the sixth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2011.
Setting
Community-based setting in longevity areas in China.
Participants
A total of 7144 Chinese elderly aged 65 years and older were included in the sample.
Measures
Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured, pulse pressure (PP) was calculated as (SBP) − (DBP) and mean arterial pressures (MAP) was calculated as 1/3(SBP) + 2/3(DBP). Cognitive function was assessed via a validated Mini-Mental State Examination (MMSE).
Results
Based on the results of generalized additive models (GAMs), U-shaped associations were identified between cognitive impairment and SBP, DBP, PP, and MAP. The cutpoints at which risk for cognitive impairment (MMSE <24) was minimized were determined by quadratic models as 141 mm Hg, 85 mm Hg, 62 mm Hg, and 103 mm Hg, respectively. In the logistic models, U-shaped associations remained for SBP, DBP, and MAP but not PP. Below the identified cutpoints, each 1-mm Hg decrease in blood pressure corresponded to 0.7%, 1.1%, and 1.1% greater risk in the risk of cognitive impairment, respectively. Above the cutpoints, each 1-mm Hg increase in blood pressure corresponded to 1.2%, 1.8%, and 2.1% greater risk of cognitive impairment for SBP, DBP, and MAP, respectively.
Conclusion
A U-shaped association between blood pressure and cognitive function in an elderly Chinese population was found. Recognition of these instances is important in identifying the high-risk population for cognitive impairment and to individualize blood pressure management for cognitive impairment prevention.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine. This is an author produced version of a paper published in Journal of the American Medical Directors Association. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Blood pressure, hypertension, hypotension, cognitive impairment, curvilinear association, elderly |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 22 Nov 2018 10:46 |
Last Modified: | 31 Jan 2019 16:23 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jamda.2016.11.011 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:138915 |
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Filename: A U-shaped association accepted manuscript.pdf
Licence: CC-BY-NC-ND 4.0