Abstract
The aim of the study was to investigate whether blood pressure (BP) differed among people with different dementia diagnoses, mild cognitive impairment, and subjective cognitive decline and whether BP differences were observed across age and sex. Our study population comprised clinical data from 6,236 patients (53.5% women) aged 45–97 years (Mean = 73.9, SD = 9.6) referred to dementia assessment in 42 outpatient clinics across Norway during 2009–2019. Patients with the following diagnoses were included: Subjective cognitive decline (SCD), Mild cognitive impairment (MCI), dementia due to Alzheimer’s disease (AD), Vascular dementia (VaD), mixed AD and VaD, and dementia in Parkinson’s disease/Lewy body disease (PDD/LBD). For all diagnostic groups, SBP increased with age until about 80 years, after which it trended downward, whereas DBP declined after 60 years of age for all diagnostic groups. Patients aged 65 years and younger with SCD had lower SBP compared to AD patients at the same age, but SBP increased rapidly with increasing age, resulting in a substantially higher SBP at 80 + years compared with all other diagnostic groups. No other differences in SBP or diastolic blood pressure (DBP) were found among patients with the different dementia diagnosis. Neither SBP nor DBP differed between MCI and AD groups. An interaction between age and gender was found for SBP at younger ages, as women started out with a lower pressure than men did but ended up with higher SBP.ConclusionAmong 80+ patients, blood pressure did not differ as a function of the various dementia disorders. The SBP for the SCD patients of various age groups differed from all other diagnostic groups, indicating either that internal regulation of BP in older people is a risk factor for dementia or that brain damage causing dementia or MCI may led to changes in blood pressure. Brain aging seems to influence SBP differently in men and women.
Highlights
It is well established that hypertension in midlife is a risk factor for vascular dementia (VaD) and dementia due to Alzheimer’s disease (AD) (Launer et al, 1995; Swan et al, 1998a,b; Kilander et al, 1998; Kivipelto et al, 2001; Yamada et al, 2003; Whitmer et al, 2005; Kimm et al, 2011; Joas et al, 2012; Livingston et al, 2017)
Even though there is a strong association between dementia and high blood pressure (BP) in midlife, the age at hypertension onset seems to be a key factor in that association (Livingston et al, 2017)
The MINI-MENTAL STATE EXAMINATION (MMSE) scores were lower for the patients with dementia than for patients with MCI and subjective cognitive decline (SCD)
Summary
It is well established that hypertension in midlife is a risk factor for vascular dementia (VaD) and dementia due to Alzheimer’s disease (AD) (Launer et al, 1995; Swan et al, 1998a,b; Kilander et al, 1998; Kivipelto et al, 2001; Yamada et al, 2003; Whitmer et al, 2005; Kimm et al, 2011; Joas et al, 2012; Livingston et al, 2017). Even though there is a strong association between dementia and high blood pressure (BP) in midlife, the age at hypertension onset seems to be a key factor in that association (Livingston et al, 2017). Whether elevated BP with late-life onset is a risk factor for the development of dementia is uncertain. One study found that midlife, but not late-life, elevated systolic BP (SBP) was related to cognitive decline (Gottesman et al, 2014). Midlife SBP as low as 130 mmHg was associated with increased risk of dementia, whereas no such association was found for SBP with late-life onset (Livingston et al, 2017; Abell et al, 2018). That midlife elevated SBP is strongly associated with the development of dementia and MCI in later life (Gottesman, 2019)
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