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Published on: April 23, 2021
Home blood pressure measurement consistency and cognitive impairment
Satoshi Hoshide1, Masafumi Nishizawa2, Hiroshi Kanegae3
1Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Abstract:
Cognitive function tends to decline with age, and individuals with mild cognitive impairment (MCI) often have difficulty completing established self-management tasks. The aim of this study was to investigate the association between the number of days within a 5-and-a-half-day period that patients took their home blood pressure (BP) as instructed and MCI assessed by the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in an elderly clinical population. We analyzed 303 ambulatory patients (mean age 77.3 ± 8.2 years) in whom MoCA-J had been assessed, who were instructed to take home BP for 1 evening and twice a day for the next five days, and who had at least one morning home BP measurement. After accounting for patient characteristics including age, sex, body mass index, drinking, smoking, prevalent cardiovascular disease, morning systolic BP and diastolic BP, and the use of antihypertensive drugs, the number of days home BP was measured was independently associated with both total MoCA-J score (estimate, 0.82; 95% confidence interval [CI], 0.43-1.21; P < 0.001) and the lowest quartile of MoCA-J score (13 or below) (odds ratio [OR], 0.72; 95%CI, 0.59-0.87; P = 0.001). Home BP measurement noncompliance (<5 days' measurement) was also independently associated with the total MoCA-J score (estimate, -2.56; 95%CI, -4.09 to -1.03; P = 0.001) and the lowest quartile of MoCA-J score (OR, 3.32; 95%CI, 1.59-6.96; P = 0.001). In conclusion, poor compliance with home BP monitoring was associated with cognitive impairment in elderly cases who had been specifically instructed to perform home BP monitoring during a designated period.
Insights
Elderly individuals with poor adherence to home blood pressure (BP) monitoring instructions showed a higher likelihood of experiencing cognitive impairment. Consistent BP measurement is linked to better cognitive function in older adults.
Area of Science:
- Gerontology
- Cardiology
- Neurology
Background:
- Cognitive function naturally declines with age, impacting self-management abilities in elderly individuals.
- Mild cognitive impairment (MCI) presents challenges in performing routine health tasks, such as medication adherence and monitoring.
Purpose of the Study:
- To examine the relationship between adherence to prescribed home blood pressure (BP) monitoring schedules and cognitive function in an elderly clinical population.
- To assess the association between the number of days home BP was measured and scores on the Japanese version of the Montreal Cognitive Assessment (MoCA-J).
Main Methods:
- Analysis of 303 ambulatory elderly patients (mean age 77.3 years) with assessed MoCA-J scores.
- Participants were instructed on a specific home BP monitoring regimen (evening, twice daily for five days) with at least one morning measurement.
- Statistical analysis accounted for demographic and clinical factors, including age, sex, BMI, lifestyle, cardiovascular disease, BP readings, and antihypertensive medication use.
Main Results:
- A higher number of days with home BP measurements was independently associated with higher total MoCA-J scores (estimate=0.82, P<0.001).
- Noncompliance with home BP monitoring (less than 5 days of measurement) was independently associated with lower total MoCA-J scores (estimate=-2.56, P=0.001).
- Poor adherence to home BP monitoring was significantly linked to a higher likelihood of having scores in the lowest quartile of MoCA-J (OR=3.32, P=0.001).
Conclusions:
- Poor compliance with instructed home blood pressure monitoring is significantly associated with cognitive impairment in elderly patients.
- Adherence to self-management tasks, like home BP monitoring, may serve as an indicator of cognitive status in older adults.
- Findings highlight the importance of monitoring adherence in elderly patients, potentially as a marker for cognitive health.
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