Hestad Knut, Engedal Knut, Horndalsveen Peter, Strand Bjørn Heine
Department of Health- and Nursing Science, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.
Department of Research, Innlandet Hospital Trust, Ottestad, Norway.
Front Aging Neurosci. 2020 Aug 31;12:257. doi: 10.3389/fnagi.2020.00257. eCollection 2020.
The aim of the study was to investigate whether blood pressure (BP) differed among people with different dementia diagnoses, mild cognitive impairment, and subjective cognitive decline and whether BP differences were observed across age and sex. Our study population comprised clinical data from 6,236 patients (53.5% women) aged 45-97 years ( = 73.9, = 9.6) referred to dementia assessment in 42 outpatient clinics across Norway during 2009-2019. Patients with the following diagnoses were included: Subjective cognitive decline (SCD), Mild cognitive impairment (MCI), dementia due to Alzheimer's disease (AD), Vascular dementia (VaD), mixed AD and VaD, and dementia in Parkinson's disease/Lewy body disease (PDD/LBD). For all diagnostic groups, SBP increased with age until about 80 years, after which it trended downward, whereas DBP declined after 60 years of age for all diagnostic groups. Patients aged 65 years and younger with SCD had lower SBP compared to AD patients at the same age, but SBP increased rapidly with increasing age, resulting in a substantially higher SBP at 80 + years compared with all other diagnostic groups. No other differences in SBP or diastolic blood pressure (DBP) were found among patients with the different dementia diagnosis. Neither SBP nor DBP differed between MCI and AD groups. An interaction between age and gender was found for SBP at younger ages, as women started out with a lower pressure than men did but ended up with higher SBP.
Among 80+ patients, blood pressure did not differ as a function of the various dementia disorders. The SBP for the SCD patients of various age groups differed from all other diagnostic groups, indicating either that internal regulation of BP in older people is a risk factor for dementia or that brain damage causing dementia or MCI may led to changes in blood pressure. Brain aging seems to influence SBP differently in men and women.
本研究的目的是调查不同痴呆诊断、轻度认知障碍和主观认知衰退患者的血压（BP）是否存在差异，以及是否观察到血压差异在年龄和性别上的分布情况。我们的研究人群包括2009年至2019年期间挪威42家门诊诊所转诊进行痴呆评估的6236例患者（53.5%为女性）的临床数据，年龄在45 - 97岁之间（平均年龄 = 73.9岁，标准差 = 9.6岁）。纳入的诊断包括：主观认知衰退（SCD）、轻度认知障碍（MCI）、阿尔茨海默病（AD）所致痴呆、血管性痴呆（VaD）、AD与VaD混合型痴呆以及帕金森病/路易体病（PDD/LBD）所致痴呆。对于所有诊断组，收缩压（SBP）随年龄增长直至约80岁，之后呈下降趋势，而舒张压（DBP）在所有诊断组中60岁后均下降。65岁及以下的SCD患者与同年龄的AD患者相比，SBP较低，但SBP随年龄增长迅速升高，导致80岁及以上时SBP显著高于所有其他诊断组。不同痴呆诊断患者之间未发现SBP或舒张压（DBP）的其他差异。MCI组和AD组之间的SBP和DBP均无差异。在较年轻年龄段发现SBP存在年龄和性别的交互作用，因为女性起始血压低于男性，但最终SBP更高。
在80岁及以上患者中，血压不因各种痴呆疾病而有所不同。各年龄组SCD患者的SBP与所有其他诊断组不同，这表明老年人血压的内部调节可能是痴呆的一个危险因素，或者导致痴呆或MCI的脑损伤可能导致血压变化。脑老化似乎对男性和女性的SBP影响不同。
