Department of Health- and Nursing Science, Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.
Department of Research, Innlandet Hospital Trust, Ottestad, Norway.
Brain Behav. 2021 Jul;11(7):e02166. doi: 10.1002/brb3.2166. Epub 2021 May 9.
It is unknown whether systolic blood pressure (SBP) drop is part of the normal aging process or due to the onset of dementia for some people. SBP drop is referring to the decrease in blood pressure often seen before death. Thus, the aim of this study was to examine whether SBP at time of diagnosis of dementia, mild cognitive impairment, or subjective cognitive decline was associated with years prior to death, and whether these associations were modified by diagnoses, age, and sex.
Participants were 2,236 patients from the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog), who died during follow-up (2009-2017) for whom we had valid blood pressure measurements. Mean age at diagnosis was 77.5 years (SD 8.3), and patients were followed for an average of 3.9 years (SD 2.2, maximum 10.5 years). The patients had subjective cognitive decline (95), mild cognitive impairment (573), dementia (1,401), or no diagnoses related to cognitive deficits (167). SBP as dependent variable was regressed against years prior to death.
In men, SBP was 1.8 mmHg lower per year closer to death (p < .01), and this trend was linear without any acceleration. This association between years prior to death and SBP in men was not modified by age, year of diagnosis, or diagnosis. There was no such association in women.
SBP was significantly lower for those diagnosed close to death in men, but not in women. This association was not modified by either age or onset of diagnosis. Thus, the lowering of SBP is more related to closeness to death and sex than to dementia or age. The downward trend was linear all 10 years prior to death, with no acceleration closer to death.
目前尚不清楚收缩压（SBP）下降是正常衰老过程的一部分，还是某些人痴呆症发病的原因。SBP 下降是指在死亡前经常观察到的血压下降。因此，本研究旨在检查痴呆症、轻度认知障碍或主观认知下降诊断时的 SBP 是否与死亡前几年相关，以及这些关联是否受诊断、年龄和性别影响。
参与者是来自挪威认知症状评估人员登记处（NorCog）的 2,236 名患者，他们在随访期间（2009-2017 年）死亡，并且我们有有效的血压测量值。诊断时的平均年龄为 77.5 岁（SD 8.3），患者平均随访 3.9 年（SD 2.2，最长 10.5 年）。患者有主观认知下降（95 人）、轻度认知障碍（573 人）、痴呆症（1,401 人）或无认知缺陷相关诊断（167 人）。将 SBP 作为因变量回归到死亡前的年份。
在男性中，距离死亡越近，SBP 每年降低 1.8mmHg（p<0.01），且该趋势呈线性，没有任何加速。这种男性死亡前年份与 SBP 之间的关联不受年龄、诊断年份或诊断的影响。女性则没有这种关联。
男性诊断为接近死亡时 SBP 明显降低，但女性则没有。这种关联不受年龄或发病时间的影响。因此，SBP 的降低与接近死亡和性别有关，而与痴呆症或年龄无关。在死亡前 10 年的整个过程中，下降趋势呈线性，且在接近死亡时没有加速。
