Blood Pressure Fluctuations Linked to Cognitive Decline in Older Adults, Study Finds
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A recent study published in the December 11, 2024, issue of Neurology®, the official journal of the American Academy of Neurology, reveals a concerning link between fluctuating blood pressure and cognitive decline in older adults. The research, which focused on Black and white participants, found that those with greater variability in their blood pressure were more likely to experience problems with thinking and memory skills. Notably,this association was stronger among Black participants compared to their white counterparts.
The study, led by Dr. anisa Dhana of Rush University in Chicago, does not establish a direct cause-and-effect relationship but highlights a notable association between blood pressure fluctuations and cognitive health. Dr. Dhana emphasized the importance of monitoring blood pressure over time to identify individuals at risk and perhaps mitigate cognitive decline.
“These results suggest that fluctuation in blood pressure is a risk factor for cognitive problems beyond the negative effects of high blood pressure itself. Older adults should be routinely monitored for their blood pressure and any changes over time so we can identify people who may have this issue and work to alleviate it, which could potentially help to prevent or delay cognitive problems.”
Anisa Dhana, MD, MSc, study author of Rush University in Chicago
The research involved 4,770 participants with an average age of 71. Of these, 66% were Black, and the remaining 34% were white. Participants underwent blood pressure assessments at the start of the study and every three years thereafter, with an average follow-up period of 10 years. Cognitive and memory tests were administered at both the beginning and end of the study.
The average blood pressure among participants was 138/78 mmHg,with high blood pressure defined as 130/80 mmHg or higher.Black participants exhibited a greater variability in systolic blood pressure (the top number) over time, with an average fluctuation of 18 mmHg compared to 16 mmHg among white participants.
Participants were categorized into three groups based on their blood pressure variability.Among Black participants, those with the highest variability scored significantly lower on cognitive tests compared to those with the least variability. The difference in scores was equivalent to 2.8 years of cognitive aging.Interestingly, participants taking blood pressure medications at the start of the study showed no significant difference in cognitive test scores based on blood pressure variability.
Dr. Dhana underscored the public health implications of these findings,stating,”With our aging society and the prevalence of Alzheimer’s disease,identifying prevention strategies to slow the decline of cognitive skills in older adults has become a public health priority. Managing blood pressure and its fluctuations is emerging as an essential risk factor that can be modified.”
One limitation of the study is its focus on Black and white participants, which may limit the generalizability of the findings to other racial groups. The research was funded by the National Institute on Aging and the Alzheimer’s Association, underscoring the growing recognition of cognitive health as a critical area of research.
As the U.S.population continues to age, these findings highlight the importance of proactive blood pressure management as a potential tool in combating cognitive decline. Future research may expand these insights to broader populations, offering hope for more effective interventions in the fight against Alzheimer’s and other forms of dementia.
Sources
The study was published in Neurology® and supported by the National Institute on Aging and the Alzheimer’s Association. For more details,visit american Academy of Neurology.
Interview: Blood Pressure Fluctuations and Cognitive Decline in Older adults
In a recent study published in Neurology®, researchers uncovered a significant link between blood pressure fluctuations and cognitive decline in older adults. This interview delves into the findings, exploring the implications for public health and the potential strategies to mitigate cognitive decline. Joining us is Dr. Anisa Dhana, the lead author of the study and an expert in geriatric medicine from Rush University in Chicago.
Understanding the Study’s Findings
Senior Editor: Dr. Dhana, thank you for joining us today. Your study highlights a concerning link between blood pressure fluctuations and cognitive decline in older adults. Can you explain what the study found and why it is indeed significant?
Dr. Dhana: Thank you for having me.The study found that older adults with greater variability in their blood pressure were more likely to experience cognitive decline, especially in terms of thinking and memory skills. what’s particularly notable is that this association was stronger among Black participants compared to their white counterparts. This suggests that blood pressure fluctuations may be a risk factor for cognitive problems beyond the well-known effects of high blood pressure itself.
The Role of Blood Pressure Variability
senior Editor: The study emphasizes the importance of monitoring blood pressure over time. Why is this variability in blood pressure so critical, and how does it impact cognitive health?
Dr. Dhana: Blood pressure variability can be thought of as the ups and downs in blood pressure readings over time. these fluctuations can be harmful because they may indicate instability in the body’s regulatory systems. Over time, this instability can lead to damage in the brain’s blood vessels, contributing to cognitive decline. By monitoring blood pressure over time, we can identify individuals at risk and potentially intervene to mitigate this decline.
Implications for Black Participants
Senior Editor: The study found a stronger association between blood pressure variability and cognitive decline among Black participants. What might explain this difference, and what are the public health implications?
Dr. Dhana: This is a complex issue, but it’s possible that Black participants may experience greater physiological stress or have a higher baseline risk for cardiovascular issues, which could exacerbate the effects of blood pressure variability. From a public health viewpoint, this underscores the need for tailored interventions and closer monitoring of blood pressure in this population.It’s also a reminder that we need to consider the broader social determinants of health that may contribute to these disparities.
Potential Interventions and Future research
Senior Editor: the study suggests that managing blood pressure and its fluctuations could be a key strategy in preventing cognitive decline. What interventions do you think are most promising, and what should future research focus on?
Dr. Dhana: There are several promising interventions,including lifestyle changes like diet,exercise,and stress management,as well as medications that can definitely help stabilize blood pressure. Future research should explore these interventions in more detail, particularly in diverse populations. We also need to investigate the mechanisms behind the link between blood pressure variability and cognitive decline to develop more targeted therapies.
Conclusion
Senior Editor: Dr. Dhana, thank you for sharing your insights. Your study highlights the importance of proactive blood pressure management in older adults and offers valuable guidance for future research and public health strategies.
Dr. Dhana: Thank you. It’s my hope that these findings will encourage more people to take control of their blood pressure and that we can continue to make progress in preventing cognitive decline as our population ages.
For more details on the study, visit the American Academy of Neurology.
