The association of pulse pressure change with memory decline in middle‐aged and older adults

Background Less is known regarding the association of pulse pressure (PP) with memory function. This study aimed to characterize long‐term patterns of PP in middle‐aged and older adults and explore their impact on subsequent change in memory function. Methods Data from the English Longitudinal Study of Ageing (ELSA, 2004–2018), were analyzed. Totally, 3587 dementia‐free participants with three measurements of BP were included. All three visits of PP (2004–2012) were used to characterize longitudinal patterns of PP by group‐based trajectory modeling (GBTM). Generalized estimating equation (GEE) models were fitted to explore the impact of PP trajectories on change in memory over a subsequent 6‐year period (2012–2018). Results Using GBTM, three distinct trajectories of PP were identified: low‐stable (38.1%), moderate‐stable (48.6%), and elevated‐increasing group (13.3%). GEE model suggested that memory declined over a 6‐year period in all PP trajectories (all P time <0.001). The overall interactions between patterns of PP changes and time with memory were statistically significant ( χ 2 interaction = 20.69, p = 0.002). Compared to participants in the low‐stable group, those in the moderate‐stable and elevated‐increasing group exhibited a faster decline in memory. Conclusions Longitudinal patterns of moderate‐stable and elevated‐increasing PP were associated with an accelerated decrease in memory. Controlling BP instability may be a promising interventional strategy for preventing cognitive decline among older adults.