Key result
Later-onset hypertension (onset age ≥65 years) was associated with a significantly higher rate of progression to dementia compared to middle-age-onset hypertension (27.0% vs 15.4%, p=0.019) in individuals with mild cognitive impairment.
Why the study?
The study was conducted to investigate the correlation between hypertension development and the progression of mild cognitive impairment to dementia in middle-aged and elderly people.
Does old-age-onset hypertension increase the risk of progression to dementia in patients with mild cognitive impairment compared to middle-age-onset hypertension?
Cohort (n=277)
No
Does old-age-onset hypertension increase the risk of progression to dementia in patients with mild cognitive impairment compared to middle-age-onset hypertension?
Later-onset hypertension is associated with a higher risk of progression from mild cognitive impairment to dementia compared to middle-age-onset hypertension.
Later-onset hypertension may accelerate MCI-to-dementia progression; leaves open whether BP timing modifies risk in prospective trials.
To investigate the correlation between hypertension development and the progression of mild cognitive impairment (MCI) to dementia in middle-aged and elderly people. A population-based longitudinal cognition survey of people aged 55+ was conducted. The hypertension onset age was estimated by self-reported information and medical insurance card records. To study the effect of later-onset hypertension on dementia, the incidence of dementia was compared between the two groups. Of 277 hypertensive MCI participants without dementia, 56 (20.22%) progressed to dementia (MCIp) over the 6-year follow-up. The proportion of MCIp participants in the old-age-onset hypertension group (≥65 years) was higher than that in the middle-age-onset hypertension group (27.0 vs. 15.4%, respectively; X 2 = 5.538, P = 0.019). In the old-age-onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7 vs. 12.6%, respectively; X 2 = 5.321, P = 0.021) and those with increased pulse pressure was higher than those without increased pulse pressure (33.3 vs. 15.4%, respectively; X 2 = 3.902, P = 0.048). However, the cox proportional hazard showed that older age was the only risk factor for MCIp (HR = 0.618, p = 0.000). These results suggest that individuals with later-onset hypertension may have greater cognition decline, even with blood pressure maintained at 130/80 mmHg with antihypertensive management.
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Qin et al. (2020) conducted a cohort in Mild Cognitive Impairment and Hypertension (n=277). Later-onset hypertension (≥65 years) vs. Middle-age-onset hypertension (<65 years) was evaluated on Progression to dementia (p=0.019). Later-onset hypertension (onset age ≥65 years) was associated with a significantly higher rate of progression to dementia compared to middle-age-onset hypertension (27.0% vs 15.4%, p=0.019) in individuals with mild cognitive impairment.
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