TY - JOUR
T1 - Late-life longitudinal blood pressure trajectories as predictor of dementia
AU - Lee, Allen T. C.
AU - Fung, Ada W. T.
AU - Richards, Marcus
AU - Chan, Wai C
AU - Chiu, Helen F. K.
AU - Lee, Ruby S. Y.
AU - Lam, Linda C. W.
N1 - Funding Information:
This work was supported by the Health and Health Services Research Fund of the Government of Hong Kong (grant number 09100071), which had no role in the study design; collection, analysis, and interpretation of data; writing of the report; and in the decision to submit the article for publication.
Publisher Copyright:
© The Author(s) 2022
PY - 2022/1/31
Y1 - 2022/1/31
N2 - While hypertension is widely recognized as a risk factor for dementia, few observational studies and clinical trials fully accounted for the effect of age on blood pressure (BP) changes prior to dementia onset. In this territory-wide population-based longitudinal study of 16,591 community-living dementia-free older adults, we followed their BP and cognitive status and tested if loss of longitudinal increase in BP in late life was associated with higher dementia risk in 6 years, with consideration of the confounding effects of hypertension, hypotension, BP variability, and other health problems and behaviours and, in the data analysis, exclusion of individuals who developed dementia within 3 years after baseline to minimize risk of reverse causality. Over 72,997 person-years of follow-up, 1429 participants developed dementia. We found that loss of longitudinal increase in systolic BP (defined as SBP increased by either < 10 mmHg or 10%) from baseline to Year 3 was independently associated with higher risk of incident dementia at Years 4 to 6 (adjusted OR 1.22, 95% CI 1.02–1.45, p = 0.03; adjusted OR 1.24, 95% CI 1.03–1.50, p = 0.02; respectively). Our findings suggest that late-life SBP trajectory changes might independently predict dementia onset and highlight the importance of including longitudinal BP monitoring in dementia risk assessment.
AB - While hypertension is widely recognized as a risk factor for dementia, few observational studies and clinical trials fully accounted for the effect of age on blood pressure (BP) changes prior to dementia onset. In this territory-wide population-based longitudinal study of 16,591 community-living dementia-free older adults, we followed their BP and cognitive status and tested if loss of longitudinal increase in BP in late life was associated with higher dementia risk in 6 years, with consideration of the confounding effects of hypertension, hypotension, BP variability, and other health problems and behaviours and, in the data analysis, exclusion of individuals who developed dementia within 3 years after baseline to minimize risk of reverse causality. Over 72,997 person-years of follow-up, 1429 participants developed dementia. We found that loss of longitudinal increase in systolic BP (defined as SBP increased by either < 10 mmHg or 10%) from baseline to Year 3 was independently associated with higher risk of incident dementia at Years 4 to 6 (adjusted OR 1.22, 95% CI 1.02–1.45, p = 0.03; adjusted OR 1.24, 95% CI 1.03–1.50, p = 0.02; respectively). Our findings suggest that late-life SBP trajectory changes might independently predict dementia onset and highlight the importance of including longitudinal BP monitoring in dementia risk assessment.
UR - http://www.scopus.com/inward/record.url?scp=85123934632&partnerID=8YFLogxK
U2 - 10.1038/s41598-022-05680-3
DO - 10.1038/s41598-022-05680-3
M3 - Journal article
C2 - 35102219
SN - 2045-2322
VL - 12
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 1630
ER -