Abstract
Objective: There is paucity of studies on the association between pulse pressure and the development of dementia, although this association has already been established. This study aimed at investigating the association between pulse pressure and the onset of dementia. Methods: We used the South Korean National Health Insurance Service claims cohort data to select 149,663 patients without dementia aged ≥60 years. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia using Cox proportional hazard models according to a pulse pressure classification (<50, 50–59, 60–69, 70–79, 80–89, or 90+). Results: Compared to women with pulse pressure <50, those with pulse pressures of 50–59, 60–69, and 90+ had higher HRs for dementia (1.14, 1.22, and 1.03, respectively). These associations were particularly strong in those on Medicaid insurance and from rural regions. However, there were no statistically significant results among men. Conclusions: A higher pulse pressure was associated with an elevated risk of dementia in women aged >60 years, particularly those on Medicaid and from rural regions, possibly due to their inability to access hypertension and other medical treatment. The establishment of dementia indicators will help to guide future health policies for the prevention of dementia.
Highlights
Dementia is a major neuropsychiatric disorder, and is the fifth most common cause of death worldwide
This study examined the association between pulse pressure and the onset of dementia among men and women
The association between high pulse pressure levels and an increased risk of developing dementia may be explained by the traditional belief that dementia is a cerebral neurodegenerative disease that occurs as a result of the accumulation of β-amyloid, as well as the method of reporting and interpreting it as a result of cerebral white matter changes due to vascular diseases [23]
Summary
Dementia is a major neuropsychiatric disorder, and is the fifth most common cause of death worldwide. The early identification of factors that increase the risk of dementia is a critical task in terms of disease prevention, management, and policymaking [2]. For the early prevention of the onset of dementia, previous studies have identified several risk factors such as social, demographic, genetic, physical, and mental health factors [3,4,5]. Blood pressure is known to be an important indicator for predicting cardiovascular disease [6]. It is recognized in the literature as a risk factor for dementia [7,8,9]. Elevated blood pressure likely to increase the risk for dementia by causing small-vessel disease and white-matter
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