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Blood pressure and cognitive function across the eighth decade: a prospective study of the Lothian Birth Cohort of 1936

By Drew Altschul, John M. Starr, Ian J Deary

Posted 19 Dec 2019
medRxiv DOI: 10.1101/2019.12.16.19015040

ObjectivesWe investigated the associations among blood pressure and cognitive functions across the eighth decade, while accounting for anti-hypertensive medication and lifetime stability in cognitive function. DesignProspective cohort study. SettingThis study used data from the Lothian Birth Cohort 1936 (LBC1936) study, which recruited participants living in the Lothian region of Scotland when aged 70 years, most of whom had completed an intelligence test at age 11 years. Participants1091 members of the LBC1936 with assessments of cognitive ability in childhood and older adulthood, and blood pressure measurements in older adulthood. Primary and secondary outcome measuresParticipants were followed up at ages 70, 73, 76, and 79, and latent growth curve models and linear mixed models were used to analyse both cognitive functions and blood pressure as primary outcomes. ResultsBlood pressure followed a quadratic trajectory in the eighth decade: on average blood pressure rose in the first waves and subsequently fell. Intercepts and trajectories were not associated between blood pressure and cognitive functions. Women with higher early-life cognitive function generally had lower blood pressure during the eighth decade. Being prescribed anti-hypertensive medication was associated with lower blood pressure, but not with better cognitive function. ConclusionsOur findings indicate an association between early-life cognitive function and later-life blood pressure, specifically among women. However, we did not find support for the hypothesis that rises in blood pressure and worse cognitive decline are associated with one another in the eighth decade. Strengths and limitations of this study- This study used direct blood pressure measurements to model a continuous blood pressure score, as well as anti-hypertensive medication data, which were used to adjust blood pressure measurements. - This study had comprehensive tests of cognitive ability measured in both childhood and old age which allowed us to investigate whether childhood and old age cognitive ability are distinctly related to blood pressure. - Latent growth curve modelling allowed us to evaluate whether changes in either blood pressure or cognitive functions have downstream associations with one another. - Larger samples and longer follow-up times, both from earlier and later in life, are needed to understand the long-term relationships among blood pressure, anti- hypertensive treatment, and cognitive functions.

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