What question did this study set out to answer?

To evaluate how longitudinal trajectories of pulse pressure relate to cognitive decline across late life, accounting for baseline systolic blood pressure and attrition.

January 1, 2016Alzheimer s & Dementia Diagnosis Assessment & Disease MonitoringOpen Access

The association between pulse pressure change and cognition in late life: Age and where you start matters

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cognitive decline (n=1954). Intervention: Longitudinal pulse pressure patterns vs. Other pulse pressure patterns. Primary outcome: Change in five cognitive domains.

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Key result

Among older adults with lower baseline systolic blood pressure, increasing or stable high pulse pressure was associated with less cognitive decline, an effect that attenuated with aging.

Why the study?

Does the longitudinal pattern of pulse pressure affect cognitive decline in older adults aged 65+ years?

Population

1954 individuals aged 65+ years from a prospective population-based cohort

Comparison

Longitudinal pulse pressure patterns vs Comparison among different longitudinal PP…

Design

Cohort

Follow-up

six annual cycles

Authors

EMEric McDadeWashington University in St. Louis ZSZhaowen SunAbbVie (United States)CLChing‐Wen LeeChinese Culture University

Discussion

Member takes

Implication

Does not support practice change; leaves open whether pulse pressure trajectories affect cognition in low-SBP older adults.

Key Points

To evaluate how longitudinal trajectories of pulse pressure relate to cognitive decline across late life, accounting for baseline systolic blood pressure and attrition.
Followed 1,954 individuals aged 65 years and older from a prospective population-based cohort across six annual assessment cycles.
Measured blood pressure and five cognitive domains, classifying longitudinal pulse pressure into four trajectories: stable normal, stable high, increasing, and decreasing.
Modeled cognitive decline relative to pulse pressure patterns after stratifying by baseline systolic blood pressure and adjusting for nonrandom attrition.
Individuals with lower baseline systolic blood pressure and either increasing or stable high pulse pressure experienced less cognitive decline, though this effect attenuated with advancing age.
Individuals with higher baseline systolic blood pressure exhibited no significant cognitive differences across pulse pressure trajectory groups, with older age consistently tracking with greater cognitive decline.

Study Design

Type

Cohort (n=1,954)

Structured PICO

Does the longitudinal pattern of pulse pressure affect cognitive decline in older adults aged 65+ years?

Population

1,954 individuals aged 65 years and older from a prospective population-based cohort followed over six annual cycles.

Exposure

Longitudinal pulse pressure (PP) patterns (stable normal, stable high, increasing, and decreasing)

Comparator

Comparison among different longitudinal PP patterns, stratified by baseline systolic blood pressure (SBP)

Outcome

Change in five cognitive domains

The association between pulse pressure and cognitive decline in older adults is dynamic and depends on age, baseline systolic blood pressure, and longitudinal pulse pressure trajectories.

Cite This Study

McDade et al. (2016) conducted a cohort in Cognitive decline (n=1,954). Longitudinal pulse pressure patterns vs. Other pulse pressure patterns was evaluated on Change in five cognitive domains. Among older adults with lower baseline systolic blood pressure, increasing or stable high pulse pressure was associated with less cognitive decline, an effect that attenuated with aging.

synapsesocial.com/papers/6a706b502163a0a01bc4a2f9 https://doi.org/10.1016/j.dadm.2016.03.008

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The association between pulse pressure change and cognition in late life: Age and where you start matters

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

The association between pulse pressure change and cognition in late life: Age and where you start matters

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider