Unpuzzling the relationship between hypertension, stroke, and Alzheimer’s disease – an observation from the Australian Imaging Biomarkers and Lifestyle Study

Abstract

AbstractBackgroundAlzheimer’s disease (AD), hypertension and stroke are common diseases in elderly people, but whether they are intrinsically linked with each other remains uncertain. The aim of this study was to investigate the risks of people who have hypertension and stroke to develop mild cognitive impairment (MCI) and AD, and if hypertension and stroke are risk factors for AD.MethodThe longitudinal data was retrieved from the Australian Imaging Biomarkers and Lifestyle Study (AIBL). The prevalence of hypertension and stroke was compared between cognitively normal (CN) participants, participants who were CN but subsequently diagnosed with MCI/AD during the study (refer to as participants exhibited cognitive decline), and participants with AD confirmed at recruitment.ResultThe prevalence of hypertension (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.05 ‐ 1.77, p = 0.018) was significantly higher in participants exhibited cognitive decline than CN participants. Interestingly, the prevalence of hypertension (OR = 0.88, 95% CI = 0.70 ‐ 1.11, p = 0.287) was comparable between CN and AD participants. This observation suggested that hypertension is a risk factor for the progression of cognitive decline. The prevalence of stroke was significantly higher in participants exhibited cognitive decline (OR = 2.04, 95% CI = 1.10 ‐ 3.79, p = 0.024) and AD participants (OR = 3.43, 95% CI = 2.09 – 5.64, p<0.001) than CN participants. This observation suggested that stroke is a risk factor for the progression of cognitive decline and AD.ConclusionThis preliminary study demonstrated that hypertension and stroke are risk factors for the progression of cognitive decline, and stroke is a risk factor for AD. Given the elevated risk in cognitive decline, the cognitive function of elderly people with hypertension or history of stroke should be monitored for timely detection of MCI and AD.