Midlife hypertension and late‐life cognition: weighting the LifeAfter90 study

INTRODUCTION Midlife hypertension is a well‐established predictor of late‐life cognitive decline; however, few population‐representative estimates of this association exist among oldest‐old cohorts. METHODS LifeAfter90 (LA90) is an ethnoracially diverse cohort of individuals aged 90+ linked to midlife multiphasic health check‐ups (MHC). We assessed executive function, semantic memory, and verbal memory at age 90+. We used stabilized inverse probability of censoring weights and linear regression to estimate the association between midlife hypertension and cognitive function in the MHC target population. RESULTS After weighting, LA90 participants ( n = 307) were similar to the MHC population on race/ethnicity, hypertension, and education. Midlife hypertension was not associated with executive function ( β = 0.03, [95% confidence interval [CI]: −0.24, 0.31]) and verbal memory ( β = −0.10 [95% CI: −0.37, 0.16]). Midlife hypertension was associated with poorer semantic memory ( β = −0.19 [95% CI: −0.44, 0.06]). DISCUSSION People with midlife hypertension averaged lower semantic memory using population‐representative models, suggesting that it may have sustained impact on learning and memory in those aged 90+.