High blood pressure and cognitive decline in mild cognitive impairment

Abstract

Objectives: To determine whether high blood pressure (BP) levels are associated with faster decline in specific cognitive domains.

Design: Prospective longitudinal cohort.

Setting: Uniform Data Set of the National Institutes of Health, National Institute on Aging Alzheimer's Disease Centers.

Participants: One thousand three hundred eighty-five participants with a diagnosis of mild cognitive impairment (MCI) and measured BP values at baseline and two annual follow-up visits.

Measurements: Neuropsychological test scores and Clinical Dementia Rating Sum of Boxes (CDR Sum) score.

Results: Participants with MCI with two or three annual occasions of high BP values (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) had significantly faster decline on neuropsychological measures of visuomotor sequencing, set shifting, and naming than those who were normotensive on all three occasions. High systolic BP values were associated as well with faster decline on the CDR Sum score.

Conclusion: Hypertension is associated with faster cognitive decline in persons at risk for dementia.

Figure 1

Performance over time as a function of having two or three occasions versus zero occasions of high blood pressure readings: (A) number of seconds to complete Trail-Making Test (TMT) Part A, (B) number of seconds to complete Trail-Making Test Part B, (C) number of correct responses on Boston Naming Test, (D) number of correct trials on the Digit Span Backward subtest.