Key result
High systolic blood pressure (≥ 160 mmHg) was associated with an increased risk of all dementia (HR 1.12) compared to 110-119 mmHg, while low blood pressure did not increase risk even in frail individuals.
Why the study?
The association between late-life blood pressure and dementia is inconclusive, and few studies have evaluated the effects of blood pressure control on dementia incidence in the frail elderly.
Does blood pressure level affect the incidence of dementia in young elderly people with and without physical frailty?
Cohort (n=804,024)
Does blood pressure level affect the incidence of dementia in young elderly people with and without physical frailty?
Hazard Ratio: 1.12 (95% CI 1.07–1.18)
p-value: p=<0.05
High blood pressure is associated with an increased risk of dementia in the young elderly, whereas low blood pressure does not increase dementia risk, regardless of physical frailty status.
BP thresholds linked to dementia risk in frail elderly warrant monitoring; leaves open whether control reduces incidence.
BACKGROUND: Midlife hypertension has been recognized as a modifiable risk factor for dementia, but association between blood pressure (BP) in late life and dementia has been inconclusive. In addition, few studies have investigated effects of BP control on dementia incidence in the frail elderly. Thus, this study aimed to investigate the association of BP and dementia incidence with concomitant consideration of physical frailty in the young elderly population. METHODS: Using the Korean National Health Information Database, we identified 804,024 subjects without history of dementia at age 66. Dementia diagnosis was defined with prescription records of anti-dementia drugs and dementia-related diagnostic codes. Physical frailty was measured using the Timed Up and Go test. Association of BP and dementia incidence with concomitant consideration of physical frailty was investigated using Cox hazards analyses. RESULTS: The risks of Alzheimer's and vascular dementia increased from systolic BP ≥ 160 and 130-139 mmHg, respectively; a significant association of dementia incidence with low BP was not observed. In the analyses stratified by the physical frailty status, low BP was not associated with increased risks of dementia within the groups both with and without physical frailty. CONCLUSIONS: High BP was associated with increased risks of dementia, especially for vascular dementia, while low BP was not associated with increased risks of any type of dementia in young elderly people, even in those with physical frailty. This study suggests the need for tight BP control in young elderly people, irrespective of frailty status, to prevent dementia and supports the current clinical guidelines of hypertension treatment.
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Cho et al. (2023) conducted a cohort in Dementia (n=804,024). Systolic blood pressure ≥ 160 mmHg vs. Systolic blood pressure 110-119 mmHg was evaluated on Incidence of all dementia (HR 1.12, 95% CI 1.07-1.18, p=<0.05). High systolic blood pressure (≥ 160 mmHg) was associated with an increased risk of all dementia (HR 1.12) compared to 110-119 mmHg, while low blood pressure did not increase risk even in frail individuals.
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