Department of Health Sciences, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Suita, Japan.
Hypertens Res. 2020 Dec;43(12):1421-1429. doi: 10.1038/s41440-020-0499-9. Epub 2020 Jul 8.
We investigated the association of systolic blood pressure (SBP) level with physical frailty and cognitive function in community-dwelling older Japanese. Using the 'Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians' survey as the baseline, we performed a cross-sectional analysis of people aged 70 ± 1 (n = 1000), 80 ± 1 (n = 978), and 90 ± 1 (n = 272) years. Medical histories and medications were collected via interviews conducted by medical professionals. Blood pressure (BP), grip strength, gait speed, and cognitive function were examined on site. Trend analysis and multiple regression analysis were used to determine the association of the SBP level with physical frailty and cognitive function. The principal finding was that the association of SBP with physical frailty and cognitive function varied depending on characteristics such as age, physical and cognitive function, and antihypertensive medication use. A lower SBP level was associated with a higher prevalence of physical frailty only among 80-year-olds who were on antihypertensive medication. A significant association was found between higher SBP and lower cognitive function among 70-year-olds, while among 90-year-olds, the opposite was found. No association was found among participants who were 80 years old or among participants of all ages without antihypertensive medication. Our finding that an inverted association between SBP and geriatric syndrome exists suggests that the treatment of older patients must be individualized to prevent geriatric syndrome.
我们调查了收缩压(SBP)水平与社区居住的日本老年人身体虚弱和认知功能的关系。利用“七十、八十、九十岁及百岁老年人调查”作为基线,我们对 70±1 岁(n=1000)、80±1 岁(n=978)和 90±1 岁(n=272)的人群进行了横断面分析。通过医学专业人员进行的访谈收集了病史和用药情况。在现场检查了血压(BP)、握力、步速和认知功能。采用趋势分析和多元回归分析来确定 SBP 水平与身体虚弱和认知功能的关系。主要发现是 SBP 与身体虚弱和认知功能的关系因年龄、身体和认知功能以及使用降压药物等特征而异。仅在服用降压药物的 80 岁老年人中,较低的 SBP 水平与身体虚弱的患病率较高相关。在 70 岁的老年人中,较高的 SBP 与较低的认知功能之间存在显著相关性,而在 90 岁的老年人中则相反。在 80 岁或所有年龄组中未服用降压药物的参与者中均未发现相关性。我们发现 SBP 与老年综合征之间存在倒置关系,这表明必须对老年患者进行个体化治疗以预防老年综合征。