Key result
Old-age onset hypertension (≥ 65 years) was associated with a higher unadjusted rate of progression to dementia compared to middle-age onset (27.0% vs 15.4%, p=0.019), though multivariate analysis identified older age as the only independent risk factor.
Why the study?
The study was conducted to investigate the effect of hypertension development on the progression of mild cognitive impairment 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)
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 (≥ 65 years) is associated with a higher rate of progression to dementia in MCI patients compared to middle-age onset, though older age itself remains the primary independent risk factor.
Old-age hypertension onset was associated with faster MCI-to-dementia progression but age-confounded; leaves open independent effect and requires prospective confirmation.
Objective To investigate the effect of hypertension development on the progression of MCI for middle aged and elderly people. Methods 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. In order to study the effect of later onset of hypertension on dementia, the incidence of dementia was compared between the two groups. Results A total of 277 h ypertensive mild cognitive impairment (MCI) participants without dementia were followed for 6 years. Overall, 56 MCI participants (20.22%) progressed to dementia (MCIp). The proportion of MCIp participants in the old-age onset hypertension group (≥ 65 years) was higher than that of middle-age onset one (27.0% vs 15.4%; X 2 = 5.538, P = 0.019). And 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%; X 2 = 5.321, P = 0.021), and the proportion of MCIp with increased pulse pressure was higher than those without increased pulse pressure (33.3% vs 15.4%; X 2 = 3.902, P = 0.048). However, the multivariate logistic regression analysis showed that older age was the only risk for MCIp (OR=0.732, p=0.029). Conclusions These results suggest that, later onset hypertension was harmful to cognition even in cases where the level of blood pressure maintained at 130/80 mmHg with antihypertensive management.
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Qin et al. (2019) conducted a cohort in Mild cognitive impairment with hypertension (n=277). Old-age onset hypertension (≥ 65 years) vs. Middle-age onset hypertension (< 65 years) was evaluated on Progression to dementia (p=0.019). Old-age onset hypertension (≥ 65 years) was associated with a higher unadjusted rate of progression to dementia compared to middle-age onset (27.0% vs 15.4%, p=0.019), though multivariate analysis identified older age as the only independent risk factor.
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