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Low Blood Pressure and Incidence of Dementia in a Very Old Sample: Dependent on Initial Cognition
Author(s) -
Guo Zhenchao,
Viitanen Matti,
Winblad Bengt,
Fratiglioni Laura
Publication year - 1999
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1999.tb01597.x
Subject(s) - medicine , dementia , incidence (geometry) , cognition , blood pressure , gerontology , sample (material) , cognitive impairment , pediatrics , psychiatry , disease , physics , optics , chemistry , chromatography
OBJECTIVE: To examine whether initially low blood pressure is related to the incidence of dementia. DESIGN: A population‐based prospective study. SETTING: The Kungsholmen district of Stockholm, Sweden PARTICIPANTS: Three hundred four nondemented subjects aged 75 to 96 years at baseline. MEASUREMENTS AND MAIN RESULTS: After an average of 3 years, 81 dementia cases were identified (67 with Alzheimer's disease cases). Compared with individuals with baseline systolic pressure of 141 to 179 mm Hg, those with systolic pressure ≤ 140 mm Hg had a significantly higher risk of dementia (relative risk (RR) = 1.9, 95% confidence interval (CI), 1.2–3.2) and Alzheimer's disease (RR = 2.2, 95% CI, 1.2–3.8). However, the RR in relation to systolic pressure ≤ 140 mm Hg was 1.3 (0.8‐2.2) for all dementia and 1.5 (0.8‐2.6) for Alzheimer's disease, when the baseline Mini‐Mental State Examination (MMSE) score was included in the model as a dichotomous variable (< 24 vs ≥ 24). Baseline MMSE <24 significantly predicted the occurrence of dementia (RR = 6.9; 95% CI, 4.3–11.1). Systolic pressure ≤ 140 mm Hg was significantly related to MMSE score < 24 at baseline. CONCLUSIONS: These data suggest that low blood pressure may be an early correlate of a dementing process although a causative effect cannot be definitely ruled out. J Am Geriatr Soc 47:723–726, 1999.