Is higher blood pressure linked to particular thinking difficulties in otherwise healthy older adults?

Details

Little is known about which specific cognitive functions are affected by elevated blood pressure (BP), or how BP changes on standing relate to cognitive impairment. This study aimed to examine the relationship of BP and its postural changes with cognitive functions in otherwise healthy older adults.

In this observational study, 70 healthy people had a mean age of 72 ± 4 years. Researchers measured systolic blood pressure (SBP) three times while participants were lying down, using a sphygmomanometer, and used the average for analysis. After 1, 3, and 5 minutes of standing, three BP measurements were obtained; orthostatic SBP changes were calculated by subtracting these standing values from the lying-down average.

Neuropsychological tests assessed short-term and long-term verbal and visual memory, visuospatial skills, and frontal-executive functions. Participants were classified as impaired on a particular cognitive performance if their score fell below the 25th percentile of the study population. Multiple logistic regression models evaluated how SBP and the magnitude of the SBP decline on standing were related to the risk of impairment on each cognitive test.

After controlling for potential confounders, each 10 mmHg higher lying-down SBP was associated with a 2.31-fold increase in the risk of impairment in psychomotor speed and set shifting—the ability to switch between tasks or mental sets—as measured by the Trailmaking Part-B test (95% confidence interval, 1.14 to 4.66). There was no significant association between cognitive functions and the SBP decline after 1, 3, or 5 minutes of standing.

The authors concluded that elevated BP was associated with selective impairment in executive function in otherwise healthy, community-dwelling older adults.