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From the Rush Institute on Healthy Aging (Drs. Hebert, Bienias, Morris, and Evans) and Rush Alzheimer’s Disease Center (Drs. Bennett and Wilson), Rush University Medical Center, Chicago, IL, and National Center for Chronic Disease Prevention and Health Promotion (Dr. Scherr), Centers for Disease Control and Prevention, Atlanta, GA.
Address correspondence and reprint requests to Dr. D.A. Evans, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 675, Chicago, IL 60612; e-mail: Denis_Evans{at}rsh.net
Objective: To examine the relation of blood pressure (BP) to subsequent decline in cognitive function among persons age 65 or over.
Methods: All persons age 65 or over in a geographically defined community were invited to participate in a longitudinal study of problems of the elderly. Interviews were conducted in the participants’ homes and included two BP measures and four tests of cognitive function. Follow-up interviews 3 and 6 years after baseline repeated the cognitive function tests. These analyses included 4,284 individuals who had baseline and at least one follow-up measure of cognitive function. The average of z scores of the individual cognitive function tests was used as a global measure of cognitive function.
Results: In random effects analyses controlling for age, sex, education, and race, there was no significant linear association of either systolic or diastolic BP with 6-year change in global cognitive function score. There was no significant curvilinear association with systolic BP. In tests for a curvilinear association with diastolic BP, there was a suggestion of increased decline among those with low or high diastolic BP (p = 0.03 for the quadratic diastolic term). At baseline, 50% of participants took some type of medication affecting BP.
Conclusion: In this community population where BP treatment was common, there was no association of either high systolic or high diastolic BP at the beginning of the observation interval with 6-year cognitive decline.
Received July 1, 2003. Accepted in final form February 10, 2004.
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