Department of Biostatistics, Indiana University, Indianapolis, Indiana.
Department of Psychiatry, Indiana University, Indianapolis, Indiana.
J Am Geriatr Soc. 2013 Jun;61(6):875-881. doi: 10.1111/jgs.12259. Epub 2013 May 6.
To report the results from a prospective cohort study on the association between blood pressure (BP) and cognitive function in elderly African Americans.
Prospective cohort study conducted from 1997 to 2009.
Community-based study in Indianapolis.
African Americans aged 65 years or older (N = 3,145).
At each assessment, participant cognitive function was measured using the Community Screening Interview for Dementia. Other measurements included BP, height, weight, education level, antihypertensive medication use, alcohol use, smoking, and history of chronic medical conditions.
Longitudinal assessments (n = 5,995) contributed by 2,721 participants with complete independent variables were analyzed using a semiparametric mixed-effects model. Systolic BP (SBP) of approximately 135 mmHg and diastolic BP (DBP) of approximately 80 mmHg were associated with optimal cognitive function after adjusting for other variables (P = .02). Weight loss with body mass index < 30.0 kg/m(2) was significantly related to poorer cognitive performance (P < .001). Older age at first assessment, lower education level; smoking; and history of depression, stroke, and diabetes mellitus were related to worse cognitive function; taking antihypertensive medication and drinking alcohol were associated with better cognitive function.
High and low BP were associated with poorer cognitive performance. A joint optimal region of SBP and DBP for cognitive function has been identified, which may provide useful clinical information on optimal BP control in cognitive health and lead to better quality of life for elderly adults.
报告一项前瞻性队列研究的结果，该研究探讨了老年非裔美国人的血压（BP）与认知功能之间的关系。
1997 年至 2009 年进行的前瞻性队列研究。
印第安纳波利斯的社区基础研究。
年龄在 65 岁或以上的非裔美国人（N=3145）。
在每次评估中，使用社区痴呆筛查访谈来测量参与者的认知功能。其他测量包括血压、身高、体重、教育程度、使用抗高血压药物、饮酒、吸烟以及慢性疾病史。
对 2721 名参与者的 5995 次纵向评估进行了分析，这些参与者具有完整的独立变量，并使用半参数混合效应模型进行分析。在调整了其他变量后，收缩压（SBP）约为 135mmHg 和舒张压（DBP）约为 80mmHg 与最佳认知功能相关（P=0.02）。体重指数（BMI）<30.0kg/m2 的体重减轻与认知表现较差显著相关（P<0.001）。首次评估时年龄较大、教育程度较低、吸烟以及患有抑郁症、中风和糖尿病史与认知功能较差相关；服用抗高血压药物和饮酒与认知功能较好相关。
高和低血压与认知表现较差相关。已经确定了 SBP 和 DBP 的联合最佳区域，这可能为认知健康中的最佳血压控制提供有用的临床信息，并为老年成年人带来更好的生活质量。
