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Blood pressure, dementia and Alzheimer's disease: the OPTIMA longitudinal study

George Razay1, Jonathan Williams, Elizabeth King

  • 1Dementia Research Centre, Launceston General Hospital, University of Tasmania, Launceston, Tas., Australia. george.razay@dhhs.tas.gov.au

Dementia and Geriatric Cognitive Disorders
|August 4, 2009
PubMed

Insights

Both high and low blood pressure (BP) levels are linked to faster cognitive decline in Alzheimer's disease (AD) patients. This finding may inform future prevention and treatment strategies for AD.

Area of Science:

  • Neurology
  • Gerontology
  • Cardiovascular Health

Background:

  • Previous research on blood pressure (BP) and dementia, including Alzheimer's disease (AD), has produced conflicting findings.
  • Some studies suggest associations with high BP, others with low BP, and some report no association.

Purpose of the Study:

  • To investigate the longitudinal impact of blood pressure on cognitive function.
  • To examine the relationship between BP parameters and cognitive decline in patients with dementia and healthy controls.

Main Methods:

  • Utilized data from the OPTIMA longitudinal study, including cognitively healthy controls and patients with dementia.
  • Measured cognitive function using the Cambridge Cognitive Examination (CAMCOG) and recorded blood pressure.
  • Employed generalized linear mixed models to analyze the dependence of CAMCOG scores on BP.

Main Results:

  • The study included 235 cognitively healthy controls, 42 with mild cognitive impairment (MCI), 141 with AD, and 59 with other dementia syndromes (ODS).
  • In AD patients, cognitive decline (CAMCOG scores) exhibited an inverted U-shaped, non-linear relationship with diastolic BP.
  • Both high (110 mm Hg) and low (60 mm Hg) diastolic BP levels were associated with accelerated cognitive decline over 5 years (p = 0.012).
  • Cognitive scores also showed an inverted U-shaped dependence on pulse pressure (p = 0.022).

Conclusions:

  • Elevated and reduced blood pressure levels are significantly associated with faster cognitive decline in individuals with Alzheimer's disease.
  • These findings highlight the potential importance of BP management in the prevention and treatment of AD.
Abstract

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