Xu Ying, McFall G Peggy, Rydén Lina, Skoog Johan, Chang Edward, Cysique Lucette A, Harris Katie, Kedwell Sarah, Lim Mei Ling, Anstey Kaarin J, Anderson Craig S, Dixon Roger A, Skoog Ingmar, Tully Phillip J, Peters Ruth
The George Institute for Global Health, Sydney, Australia.
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Cereb Circ Cogn Behav. 2024 Dec 16;8:100375. doi: 10.1016/j.cccb.2024.100375. eCollection 2025.
Cumulative blood pressure metrics may provide greater precision for measuring temporal risk exposure, especially in later life where data are mixed regarding associations of high blood pressure (BP) on cognitive function. We examined the relationship between greater cumulative exposure to high BP in later life and several domains of cognitive function.
Individual cognitive assessment scores and BP measurements in older adults (age ≥70 years) at baseline and over approximately 8 years of follow-up were available in the population-based Canadian Victoria Longitudinal Study (VLS) and Swedish Gothenburg H70 Birth Cohort Studies (H70). Linear mixed models were used to quantify associations between cumulative systolic and diastolic BP and change in cognitive scores.
Each additional 100mmHg increase in cumulative BP was related to greater decline in the Rey Auditory Verbal Learning Test (RAVLT) List A, trials 1-5 total score over follow-up: -0.23 (95% confidence interval [CI] -0.32, -0.13) for systolic BP and -0.41 (95%CI -0.58, -0.23) for diastolic BP. Similarly increases cumulative systolic and diastolic BP were related to greater declines Digit Symbol Substitution Task (DSS) scores: -0.59 (95%CI -0.80, -0.38) and -1.04 (95% CI -1.40, -0.67), respectively. There were no associations of cumulative BP and temporal changes in general cognition, other measures of verbal episodic memory, or semantic fluency.
Higher cumulative BP is associated with greater declines in RAVLT measured immediate memory span and complex attention, information processing speed and visuospatial scanning in older adults, but the scale of change is small. Additional research is required to further define these relationships and identify opportunities for prevention.
累积血压指标可能为测量随时间变化的风险暴露提供更高的精度，尤其是在晚年，关于高血压（BP）与认知功能之间的关联数据较为复杂。我们研究了晚年累积暴露于高血压与认知功能多个领域之间的关系。
基于人群的加拿大维多利亚纵向研究（VLS）和瑞典哥德堡H70出生队列研究（H70）提供了老年人（年龄≥70岁）在基线时以及约8年随访期间的个体认知评估分数和血压测量值。使用线性混合模型来量化累积收缩压和舒张压与认知分数变化之间的关联。
累积血压每额外增加100mmHg，与随访期间雷伊听觉词语学习测验（RAVLT）A表、第1 - 5次试验总分的更大下降相关：收缩压导致的下降为-0.23（95%置信区间[CI] -0.32，-0.13），舒张压导致的下降为-0.41（95%CI -0.58，-0.23）。同样，累积收缩压和舒张压的增加与数字符号替换测验（DSS）分数的更大下降相关，分别为-0.59（95%CI -0.80，-0.38）和-1.04（95%CI -1.40，-0.67）。累积血压与总体认知、言语情景记忆的其他测量指标或语义流畅性的时间变化之间没有关联。
较高的累积血压与老年人RAVLT测量的即时记忆广度、复杂注意力、信息处理速度和视觉空间扫描能力的更大下降相关，但变化幅度较小。需要进一步的研究来进一步明确这些关系并确定预防机会。
