Association of Midlife to Late-Life Blood Pressure Patterns With Incident Dementia

IMPORTANCE: The association between late-life blood pressure (BP) and cognition may depend on the presence and chronicity of past hypertension. Late-life declines in blood pressure following prolonged hypertension may be associated with poor cognitive outcomes. OBJECTIVE: To examine the association...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2019-08, Vol.322 (6), p.535-545
Main Authors: Walker, Keenan A, Sharrett, A. Richey, Wu, Aozhou, Schneider, Andrea L. C, Albert, Marilyn, Lutsey, Pamela L, Bandeen-Roche, Karen, Coresh, Josef, Gross, Alden L, Windham, B. Gwen, Knopman, David S, Power, Melinda C, Rawlings, Andreea M, Mosley, Thomas H, Gottesman, Rebecca F
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Arteriosclerosis
Atherosclerosis
Blood Pressure
Blood Pressure Determination
Cognition
Cognitive ability
Cognitive Dysfunction - complications
Cognitive Dysfunction - etiology
Cohort Studies
Communities
Dementia
Dementia - etiology
Dementia disorders
Evaluation
Female
Humans
Hypertension
Hypertension - complications
Hypotension
Hypotension - complications
Impairment
Longitude
Male
Middle Aged
Original Investigation
Population studies
Prospective Studies
Risk
Risk Factors
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Summary:IMPORTANCE: The association between late-life blood pressure (BP) and cognition may depend on the presence and chronicity of past hypertension. Late-life declines in blood pressure following prolonged hypertension may be associated with poor cognitive outcomes. OBJECTIVE: To examine the association of midlife to late-life BP patterns with subsequent dementia, mild cognitive impairment, and cognitive decline. DESIGN, SETTING, AND PARTICIPANTS: The Atherosclerosis Risk in Communities prospective population-based cohort study enrolled 4761 participants during midlife (visit 1, 1987-1989) and followed-up over 6 visits through 2016-2017 (visit 6). BP was examined over 24 years at 5 in-person visits between visits 1 and 5 (2011-2013). During visits 5 and 6, participants underwent detailed neurocognitive evaluation. The setting was 4 US communities: Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and Minneapolis, Minnesota. Follow-up ended on December 31, 2017. EXPOSURES: Five groups based on longitudinal patterns of normotension, hypertension (>140/90 mm Hg), and hypotension (
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2019.10575