A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly.

dc.contributor.author

Lv, Yue-Bin

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Zhu, Peng-Fei

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Yin, Zhao-Xue

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Kraus, Virginia Byers

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Threapleton, Diane

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Chei, Choy-Lye

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Brasher, Melanie Sereny

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Zhang, Juan

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Qian, Han-Zhu

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Mao, Chen

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Matchar, David Bruce

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Luo, Jie-Si

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Zeng, Yi

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Shi, Xiao-Ming

dc.date.accessioned

2021-05-05T07:44:21Z

dc.date.available

2021-05-05T07:44:21Z

dc.date.issued

2017-02

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2021-05-05T07:44:18Z

dc.description.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.
dc.identifier

S1525-8610(16)30530-8

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1525-8610

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1538-9375

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https://hdl.handle.net/10161/22810

dc.language

eng

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Elsevier BV

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Journal of the American Medical Directors Association

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10.1016/j.jamda.2016.11.011

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Humans

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Hypertension

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Hypotension

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Risk Factors

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Longitudinal Studies

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Cross-Sectional Studies

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Cognition Disorders

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Aged

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Aged, 80 and over

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China

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Female

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Male

dc.title

A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly.

dc.type

Journal article

duke.contributor.orcid

Kraus, Virginia Byers|0000-0001-8173-8258

duke.contributor.orcid

Matchar, David Bruce|0000-0003-3020-2108

pubs.begin-page

193.e7

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193.e13

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2

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School of Medicine

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Duke Molecular Physiology Institute

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Orthopaedics

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Pathology

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Medicine, Rheumatology and Immunology

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Duke

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Institutes and Centers

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Clinical Science Departments

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Medicine

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Duke Clinical Research Institute

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Duke Global Health Institute

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Medicine, General Internal Medicine

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University Institutes and Centers

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Institutes and Provost's Academic Units

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Duke Population Research Institute

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Center for Population Health & Aging

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Duke Population Research Center

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Center for the Study of Aging and Human Development

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Medicine, Geriatrics

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Sanford School of Public Policy

pubs.publication-status

Published

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18

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