| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Einstein Aging Study (Drs. Verghese, Lipton, Hall, and Kuslansky, M.J. Katz) and Departments of Neurology (Drs. Verghese, Lipton, Hall, and Kuslansky, M.J. Katz)and Epidemiology and Population Health (Drs. Lipton and Hall), Albert Einstein College of Medicine, Bronx, NY.
Address correspondence and reprint requests to Dr. J. Verghese, Einstein Aging Study, Albert Einstein College of Medicine, 1165 Morris Park Ave., Rm. 338, Bronx, NY 10461; e-mail: jverghes{at}aecom.yu.edu
Background: The role of blood pressure (BP) as a risk factor for dementia is complex and may be age dependent. In very old individuals, low BP might increase risk for dementia, perhaps by reducing cerebral perfusion pressure.
Methods: The association between BP and dementia was examined in the Bronx Aging Study, a prospective study of 488 community-dwelling elderly individuals over age 75, dementia-free at baseline (1980 to 1983) and followed at 12- to 18-month intervals. Subjects with baseline BP and with at least one follow-up visit were included (n = 406). Incident dementia was diagnosed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders (3rd rev. ed.).
Results: Over 21 years (median 6.7 years), 122 subjects developed dementia (65 Alzheimer’s disease [AD], 28 vascular dementia, 29 other dementias). Relative risk of dementia increased for each 10-mm Hg decrement in diastolic (hazard ratio [HR] 1.20, 95% CI 1.03 to 1.40) and mean arterial (HR 1.16, 95% CI 1.02 to 1.32) pressure, adjusted for age, sex, and education. Low diastolic BP significantly influenced risk of developing AD but not vascular dementia. Upon examination of groups defined by BP, mildly to moderately raised systolic BP (140 to 179 mm Hg) was associated with reduced risk for AD (HR vs normal systolic BP group 0.55, 95% CI 0.32 to 0.96), whereas low diastolic BP (
70 mm Hg) was associated with increased risk of AD (HR vs normal diastolic BP group 1.91, 95% CI 1.05 to 3.48). Subjects with persistent low BP over 2 years had higher risk of developing dementia (HR 2.19, 95% CI 1.27 to 3.77).
Conclusions: Low diastolic pressure is associated with higher risk of dementia in elderly individuals over age 75. Dementia risk was higher in subjects with persistently low BP.
Received March 23, 2003. Accepted in final form September 8, 2003.
Presented in part at the 54th Annual Meeting of the American Academy of Neurology, April 16, 2002, Denver, CO.
This article has been cited by other articles:
|
|
 |
|
  S. P. Kennelly, B. A. Lawlor, and R. A. Kenny Review: Blood pressure and dementia -- a comprehensive review Therapeutic Advances in Neurological Disorders, July 1, 2009; 2(4): 241 - 260. [Abstract] [PDF]
|
|
|
|
 |
|
 M.D.M. Haag, A. Hofman, P. J. Koudstaal, M. M.B. Breteler, and B. H.C. Stricker Duration of antihypertensive drug use and risk of dementia: A prospective cohort study Neurology, May 19, 2009; 72(20): 1727 - 1734. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Hoffman, J. Schmeidler, G. T. Lesser, M. S. Beeri, D. P. Purohit, H. T. Grossman, and V. Haroutunian Less Alzheimer disease neuropathology in medicated hypertensive than nonhypertensive persons Neurology, May 19, 2009; 72(20): 1720 - 1726. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Knopman Hypertension and late-life dementia: A real link? Neurology, May 19, 2009; 72(20): 1716 - 1717. [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Silverman, M. S. Beeri, J. Schmeidler, C. Rosendorff, G. Angelo, R. S. Mavris, H. T. Grossman, G. A. Elder, J. Carrion-Baralt, and R. West C-reactive protein and memory function suggest antagonistic pleiotropy in very old nondemented subjects Age Ageing, March 1, 2009; 38(2): 237 - 241. [Full Text] [PDF]
|
|
|
|
 |
|
 N. Coley, S. Andrieu, V. Gardette, S. Gillette-Guyonnet, C. Sanz, B. Vellas, and A. Grand Dementia Prevention: Methodological Explanations for Inconsistent Results Epidemiol. Rev., November 1, 2008; 30(1): 35 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Knecht, H. Wersching, H. Lohmann, M. Bruchmann, T. Duning, R. Dziewas, K. Berger, and E. B. Ringelstein High-Normal Blood Pressure Is Associated With Poor Cognitive Performance Hypertension, March 1, 2008; 51(3): 663 - 668. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Andel, M. Crowe, N. L. Pedersen, L. Fratiglioni, B. Johansson, and M. Gatz Physical Exercise at Midlife and Risk of Dementia Three Decades Later: A Population-Based Study of Swedish Twins J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2008; 63(1): 62 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Cummings, R. Doody, and C. Clark Disease-modifying therapies for Alzheimer disease: Challenges to early intervention Neurology, October 16, 2007; 69(16): 1622 - 1634. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. van den Berg, G. J. Biessels, A. J.M de Craen, J. Gussekloo, and R.G.J. Westendorp The metabolic syndrome is associated with decelerated cognitive decline in the oldest old Neurology, September 4, 2007; 69(10): 979 - 985. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L.C. Vogels, P. Scheltens, J. M. Schroeder-Tanka, and H. C. Weinstein Cognitive impairment in heart failure: A systematic review of the literature Eur J Heart Fail, May 1, 2007; 9(5): 440 - 449. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Hildrum, A. Mykletun, E. Stordal, I. Bjelland, A. A Dahl, and J. Holmen Association of low blood pressure with anxiety and depression: the Nord-Trondelag Health Study J Epidemiol Community Health, January 1, 2007; 61(1): 53 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Shah, R. S. Wilson, J. L. Bienias, Z. Arvanitakis, D. A. Evans, and D. A. Bennett Blood pressure and lower limb function in older persons. J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2006; 61(8): 839 - 843. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kurth and G. Logroscino Can We Escape Stroke and Alzheimer Disease? Stroke, February 1, 2006; 37(2): 279 - 280. [Full Text] [PDF]
|
|
|
|
|
|
G. Zuccala, R. Bernabei, and J. Verghese Low blood pressure and the risk of dementia in very old individuals Neurology, August 10, 2004; 63(3): 598 - 599. [Full Text] [PDF]
|
|
|
|
|
|
C. Qiu, E. von Strauss, B. Winblad, and L. Fratiglioni Decline in Blood Pressure Over Time and Risk of Dementia: A Longitudinal Study From the Kungsholmen Project Stroke, August 1, 2004; 35(8): 1810 - 1815. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 More Data, More Questions on Hypotension and Dementia Risk in the Elderly Journal Watch Neurology, April 9, 2004; 2004(409): 6 - 6. [Full Text]
|
|
|
|
 |
|
 An Association Between Low BP and Alzheimer Disease? Journal Watch Cardiology, February 20, 2004; 2004(220): 6 - 6. [Full Text]
|
|
|
|
 |
|
 An Association Between Low BP and Alzheimer Disease? Journal Watch (General), January 23, 2004; 2004(123): 3 - 3. [Full Text]
|
|
Read all Correspondence
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
