scholarly journals Is The Association Between Cognitive Decline And Mortality Modified By High Blood Pressure Among The Oldest Old?

2022 ◽  
Author(s):  
Jun Duan ◽  
Napoleon Bellua Sam ◽  
Shi-Jia Wang ◽  
Yan Liu
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Proportional Hazards Model ◽  
Oldest Old ◽  
Potential Effect ◽  
Cox Proportional Hazards Model ◽  
Normal Cognitive Function ◽  
Cvd Mortality

Abstract Few studies have systematically explored the association between cognitive decline and mortality among the aged (above 80 years old) and also have limited evidence of the potential effect modifiers between them. Therefore, this study included 14,891 aged (mean age: 90.3±7.5 years) and 10,904 aged deaths with 34,486 person-years were observed. Cognitive decline was continuous and stratified into ten categories. Potential effect modifiers were identified as age, sex, blood pressure (BP) and high BP related diseases, including hypertension and cardiovascular disease (CVD) mortality. Cox proportional hazards model was used to evaluate the relationship between them after adjusting for demographic characteristics, socioeconomic status, lifestyle factors, leisure activities and health conditions. Compared to those with maintained high normal cognitive function, participants who have declined to severe cognitive impairment from a high normal cognitive function, low normal cognitive function and mild cognitive impairment have 55%, 56% and 63% mortality risks respectively. The multivariable-adjusted model indicated that the aged with decreasing one more point in MMSE score per year, had around 4% higher risk of mortality. There was a significant association of interaction of cognitive decline-mortality and sex (P=0.013) as well as hypertension (P=0.004) but with no significant association among age (P=0.277), high BP (P=0.082), and CVD mortality (P=0.058). Our findings suggest that periodic screen cognitive decline and strengthen BP control may be necessary for public health.

scholarly journals Is the Association Between Cognitive Decline and Mortality Modified by High Blood Pressure Among the Oldest Old?

2021 ◽  
Author(s):  
Jun Duan ◽  
Napoleon Bellua Sam ◽  
Gui-Ling Liang ◽  
Shi-Jia Wang ◽  
Han-Jie Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Oldest Old ◽  
Potential Effect ◽  
Mortality Risks ◽  
Normal Cognitive Function ◽  
Cvd Mortality

Abstract BackgroundFew studies have systematically explored the association between cognitive decline and mortality among the oldest old (above 80 years old) and also have limited evidence of the potential effect modifiers between them. The purpose of this study is to evaluate the association between cognitive decline, stratified by detailed levels, and mortality as well as the potential effect modifiers between them.MethodsThis study included 14,891 oldest old (mean age: 90.3±7.5 years) and 10,904 oldest old deaths with 34,486 person-years were observed. Cognitive decline was continuous and stratified into ten categories. Potential effect modifiers were identified as age, sex, blood pressure (BP) and high BP related diseases, including hypertension and cardiovascular disease (CVD) mortality. Cox proportional hazards model was used to evaluate the relationship between them after adjusting for demographic characteristics, socioeconomic status, lifestyle factors, leisure activities and health conditions.ResultsIn the ten categories, compared to those with maintained high normal cognitive function, participants who have declined to severe cognitive impairment from a high normal cognitive function, low normal cognitive function and mild cognitive impairment have 55%, 56% and 63% mortality risks respectively. Cognitive function declined to mild cognitive impairment from a high normal cognitive function and low normal cognitive function with mortality risks 25% and 17% respectively. The multivariable-adjusted model indicated that the oldest old with decreasing one more point in MMSE score per year, had around 4% higher risk of mortality. There was a significant association of interaction of cognitive decline-mortality and sex (P=0.013) as well as hypertension (P=0.004) but with no significant association among age (P=0.277), high BP (P=0.082), and CVD mortality (P=0.058).ConclusionsOur findings suggest that cognitive decline is associated with an elevated risk of all-cause mortality among the oldest old, even at a low level of cognitive decline. Low BP, non-hypertension and non-CVD mortality may be potentially beneficial in the cognitive decline-mortality association.

scholarly journals ASSOCIATION BETWEEN BLOOD PRESSURE AND COGNITIVE FUNCTION OF COMMUNITY-DWELLING OLDEST OLD IN OKINAWA, JAPAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S643-S643
Author(s):  
Yukihiro Namihira ◽  
Takashi Tokashiki ◽  
Akio Ishida ◽  
Yusuke Ohya ◽  
Hiroko H Dodge
Keyword(s):  
Blood Pressure ◽  
Cognitive Function ◽  
Arterial Stiffness ◽  
Cognitive Decline ◽  
Pulse Pressure ◽  
Cognitive Aging ◽  
Oldest Old ◽  
Community Dwelling ◽  
Vascular Stiffness ◽  
High Cognitive Function

Abstract Background: Adults 80 years and older are the fastest-growing segment of the Japanese population and face a high risk of cognitive decline. There are some evidences connecting hypertension to cognitive decline. In mid-life hypertension is known to have influence the cognitive decline in older age. However, a few study have examined the association between hypertension or vascular stiffness and cognitive function among elderly over 80 years old. We analyzed the associations between vascular stiffness and cognitive function among relatively healthy community-dwelling non-demented oldest old. Method: Data came from the Keys to Optimal Cognitive Aging (KOCOA) study; an ongoing cohort of relatively healthy volunteers aged over 80 years old, living in Okinawa, Japan. In 2017, 105 non-demented (Clinical Dementia Rating < 1) subjects completed three kinds of examination for vascular function (75 % female, mean age (SD) 84.0 (3.0)). We categorized subjects into low and high cognitive function groups using Montreal Cognitive Assessment (MoCA) (25/26 as a cutpoint). Logistic regression models were used to examine the association between cognitive and vascular functions. Results: Narrower pulse pressure, an indicator of lower arterial stiffness, was associated with better cognitive function among subjects, after adjusting for gender, age, and education (p≦0.05), although systolic and diastolic blood pressure were not. Conclusion: Our findings suggest that narrower pulse pressure is related with cognitive preservation. The present study supports the hypothesis that lower arterial stiffness is related with better cognitive function even among the oldest old.

scholarly journals Short-Term and Long-Term Blood Pressure Changes and the Risk of All-Cause and Cardiovascular Mortality

2019 ◽  
Vol 2019 ◽  
pp. 1-15
Author(s):  
Yue Dai ◽  
Yali Wang ◽  
Yanxia Xie ◽  
Jia Zheng ◽  
Rongrong Guo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
National Committee ◽  
Short Term ◽  
Blood Pressure Elevation ◽  
Long Term Study ◽  
All Cause Mortality ◽  
Cvd Mortality

Background. Few studies compared the effects of BP changes in short- and long-terms on all-cause mortality and CVD mortality. Methods. We performed a 12.5-year follow-up study to examine the association between short- (2008 to 2010) and long-term [baseline (2004-2006) to 2010] BP changes and the risk of mortality (2010 to 2017) in the Fuxin prospective cohort study. The Cox proportional hazards model was used for this study, and the average BP was stratified according to the Seven Joint National Committee (JNC7). Results. We identified 1496 (805 CVD deaths) and 2138 deaths (1222 CVD deaths) in short- and long-term study. Compared with BP maintainer, in short-term BP changes, for participants from normotension or prehypertension to hypertension, the hazards ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality were 1.948 (1.118-3.392) and 1.439 (1.218-1.700), respectively, while for participants from hypertension to prehypertension, the HRs (95% CIs) were 0.766 (0.638-0.899) for all-cause mortality and 0.729 (0.585-0.908) for CVD mortality, respectively. In long-term BP changes, for participants from normotension or prehypertension to hypertension, the HRs (95% CIs) of all-cause mortality were 1.738 (1.099-2.749) and 1.203 (1.023-1.414), and they were 2.351 (1.049-5.269) and 1.323 (1.047-1.672) for CVD mortality, respectively. In addition, the effects of short-term BP changes on all-cause and CVD mortality, measured as regression coefficients (β), were significantly greater than those in long-term change (all P<0.05). Conclusions. Our study emphasizes that short-term changes in BP have a greater impact on all-cause and CVD mortality than long-term changes and assess the cut-off value of the changes in blood pressure elevation.

Association of Neutrophil-Lymphocyte Ratio with Mild Cognitive Impairment in Elderly Chinese Adults: A Case-control Study

2020 ◽  
Vol 16 (14) ◽  
pp. 1309-1315
Author(s):  
Peilin An ◽  
Xuan Zhou ◽  
Yue Du ◽  
Jiangang Zhao ◽  
Aili Song ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Predictive Values ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Elderly Chinese ◽  
Normal Cognitive Function ◽  
The Absolute

Background: Inflammation plays a significant role in the pathophysiology of cognitive impairment in previous studies. Neutrophil-lymphocyte ratio (NLR) is a reliable measure of systemic inflammation. Objective: The aim of this study was to investigate the association between NLR and mild cognitive impairment (MCI), and further to explore the diagnostic potential of the inflammatory markers NLR for the diagnosis of MCI in elderly Chinese individuals. Methods: 186 MCI subjects and 153 subjects with normal cognitive function were evaluated consecutively in this study. Neutrophil (NEUT) count and Lymphocyte (LYM) count were measured in fasting blood samples. The NLR was calculated by dividing the absolute NEUT count by the absolute LYM count. Multivariable logistic regression was used to evaluate the potential association between NLR and MCI. NLR for predicting MCI was analyzed using Receiver Operating Characteristic (ROC) curve analysis. Results: The NLR of MCI group was significantly higher than that of subjects with normal cognitive function (2.39 ± 0.55 vs. 1.94 ± 0.51, P < 0.001). Logistic regression analysis showed that higher NLR was an independent risk factor for MCI (OR: 4.549, 95% CI: 2.623-7.889, P < 0.001). ROC analysis suggested that the optimum NLR cut-off point for MCI was 2.07 with 73.66% sensitivity, 69.28% specificity, 74.48% Positive Predictive Values (PPV) and 68.36% negative predictive values (NPV). Subjects with NLR ≥ 2.07 showed higher risk relative to NLR < 2.07 (OR: 5.933, 95% CI: 3.467-10.155, P < 0.001). Conclusion: The elevated NLR is significantly associated with increased risk of MCI. In particular, NLR level higher than the threshold of 2.07 was significantly associated with the probability of MCI.

scholarly journals The Role of Daily Social Interactions in Detecting Mild Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 598-598
Author(s):  
Ruixue Zhaoyang ◽  
Stacey Scott ◽  
Eric Cerino ◽  
Martin Sliwinski
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Social Interactions ◽  
Social Relationships ◽  
Daily Basis ◽  
Community Dwelling ◽  
Normal Cognitive Function ◽  
Social Markers

Abstract Social relationships play an important role in cognitive health and aging. However, it is unclear how older adult’s cognitive function affects their everyday social interactions, especially for those with mild cognitive impairment (MCI). This study examined whether older adults with intact cognition vs. MCI differed in their daily social interactions. Community-dwelling older adults from the Einstein Aging Study (N=244, 70-91 yrs) reported their social interactions five times daily for 14 consecutive days using smartphones. Compared to those with normal cognitive function, older adults with MCI reported less frequent positive social interactions (p=0.012) and in-person social activities (p=0.006) on a daily basis. These two groups, however, did not show significant differences in their social relationships assessed by a conventional global questionnaire. The results support that, relative to global social relationships, daily social interactions are more sensitive, ecologically valid social markers that can facilitate the early detection of MCI.

Long-Term Blood Pressure Variability Increases Risks of Dementia and Cognitive Decline: A Meta-Analysis of Longitudinal Studies

Hypertension ◽  
2021 ◽  
Author(s):  
Pingping Jia ◽  
Helen W.Y. Lee ◽  
Joyce Y.C. Chan ◽  
Karen K.L. Yiu ◽  
Kelvin K.F. Tsoi
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Longitudinal Studies ◽  
Meta Analysis ◽  
Hazard Ratio ◽  
Literature Searches ◽  
Meta Regression

High blood pressure (BP) is considered as an important risk factor for cognitive impairment and dementia. BP variability (BPV) may contribute to cognitive function decline or even dementia regardless of BP level. This study aims to investigate whether BPV is an independent predictor for cognitive impairment or dementia. Literature searches were performed in MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science to May 2021. Longitudinal studies that assessed the risk of dementia or cognitive impairment with BPV as the predictor was included. Meta-analysis and meta-regression were performed to evaluate the effect of BPV on the risk of dementia or cognitive impairment. A total of 5919 papers were identified, and 16 longitudinal studies were included, which had >7 million participants and a median age from 50.9 to 79.9 years and a median follow-up of around 4 years. Thirteen studies reported visit-to-visit BPV and concluded that systolic BPV increases the risk of dementia with a pooled hazard ratio of 1.11 (95% CI, 1.05–1.17), and increases the risk of cognitive impairment with a pooled hazard ratio of 1.10 (95% CI, 1.06–1.15). Visit-to-visit diastolic BPV also increased the risk of dementia and cognitive decline. A meta-regression revealed a linear relationship between higher BPV and risks of dementia and cognitive impairment. Similar findings were observed in the studies with day-to-day BPV. This study suggests that long-term BPV is an independent risk factor for cognitive impairment or dementia, so an intervention plan for reducing BPV can be a target for early prevention of dementia.

scholarly journals Premature Ventricular Complexes on Screening Electrocardiogram and Risk of Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (5) ◽  
pp. 1365-1367 ◽  
Author(s):  
Sunil K. Agarwal ◽  
Jennifer Chao ◽  
Frederick Peace ◽  
Suzanne E. Judd ◽  
Brett Kissela ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Racial Differences ◽  
Proportional Hazards Model ◽  
Geographic Region ◽  
Left Ventricular ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Premature Ventricular Complexes ◽  
Increased Risk

Background and Purpose— Premature ventricular complexes (PVCs) detected from long-term ECG recordings have been associated with an increased risk of ischemic stroke. Whether PVCs seen on routine ECG, commonly used in clinical practice, are associated with an increased risk of ischemic stroke remains unstudied. Methods— This analysis included 24 460 participants (aged, 64.5+9.3 years; 55.1% women; 40.0% blacks) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who were free of stroke at the time of enrollment. PVCs were ascertained from baseline ECG (2003–2007), and incident stroke cases through 2011 were confirmed by an adjudication committee. Results— A total of 1415 (5.8%) participants had at least 1 PVC at baseline, and 591 developed incident ischemic stroke during an average (SD) follow-up of 6.0 (2.0) years. In a cox proportional hazards model adjusted for age, sex, race, geographic region, education, previous heart disease, systolic blood pressure, blood pressure–lowering medications, current smoking, diabetes mellitus, left ventricular hypertrophy by ECG, and aspirin use and warfarin use, the presence of PVCs was associated with 38% increased risk of ischemic stroke (hazard ratio [95% confidence interval], 1.38 [1.05–1.81]). Conclusions— PVCs are common on routine screening ECGs and are associated with an increased risk of ischemic stroke.

The Validity of the Norwegian Version of the Cognitive Function Instrument

2018 ◽  
Vol 46 (3-4) ◽  
pp. 217-228 ◽  
Author(s):  
Mona Michelet ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Anne Lund ◽  
Guro Hanevold Bjørkløf ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Reference Group ◽  
Area Under The Curve ◽  
The Self ◽  
Norwegian Version ◽  
People With Dementia ◽  
Diagnosis Of Dementia ◽  
Proxy Version

Background/Aims: A timely diagnosis of dementia is important, and the Cognitive Function Instrument (CFI) is a newly developed instrument to screen for cognitive decline. The aim of this study was to evaluate the validity and internal consistency of the Norwegian version of the CFI. Methods: We included 265 participants with dementia, mild cognitive impairment (MCI), subjective cognitive impairment (SCI), and a reference group without subjective or assessed cognitive decline. The participants and their relatives answered the self- and proxy-rated versions of the CFI. Results: The Norwegian CFI had power to discriminate between people with dementia and with MCI, SCI, and the reference group. The proxy version had better power than the self-rated version in our participants (area under the curve [AUC] proxy-rated varying from 0.79 to 0.99, AUC self-rated varying from 0.56 to 0.85). Conclusion: The Norwegian CFI was found to be a useful, valid, and robust instrument.

Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Nutrition Survey

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.

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