Hypertension, brain training and cognition in the healthy adults aged over 50 years: An online longitudinal study

Abstract

AbstractBackgroundThere have been no studies that investigate if cognitive tasks that have been proven to delay the progress of cognitive decline confound the relationship between Hypertension (HT) and cognitive function. We aimed to investigate whether brain training has a modifying effect on the relationship between HT and cognitive decline.MethodParticipants were from Platform for Research Online to Investigate Cognition and Genetics in Ageing (PROTECT), a longitudinal online study which collected information on demographic, medical and cognitive function annually, who underwent brain training intervention (BT) delivered online throughout the year; participants could choose to undertake it as many times as they wanted or not at all. Digit span, Paired associates, Self‐ordered search and verbal reasoning tests were used to test cognitive functions. Regression models was done to assess influence of hypertension and BT on cognition at follow up and whether the frequency of BT had a modifying effect on the relationship between hypertension and cognitive function from baseline to one year.Results5726 participants over the age of 50 participated in BT with mean age 61.9 (±7.05) and 77% women. 1448 (25%) participants with HT had lower scores on all the 4 cognitive measures after adjusting for BT and potential confounders, although only the association with Digit Span test was significant (beta=‐0.031 p=0.03). After testing for interactions, there was an association of HT with verbal reasoning score change for those with BT (beta=‐0.097, p=0.048). There was also an interaction between BT frequency (higher number of attempts) and HT for paired associate learning (interaction beta=‐0.118, p=0.008), whereby frequency of BT was associated with positive change (improvement) only in individuals without HT (beta=0.121, p<0.001), whereas no association was observed in individuals with HT (p>0.05).ConclusionsHT was associated with lower cognition and also seems to modify the association of BT with cognition. There was improvement of all 4 cognition with increasing number of BT attempts irrespective of HT status, and improvement in Paired Associate scores over one year for participants without HT, implying a potential beneficial role for BT. However, this needs to be validated in larger and longitudinal studies.