Key result
Higher SBP is linked to worse cognition in preserved MMSE but reversed in impaired MMSE.
Why the study?
Elevated systolic blood pressure is associated with cognitive dysfunction, but blood pressure may decrease with advanced cognitive dysfunction, leaving the turning point in their relationship unclear.
How does systolic blood pressure relate to cognitive function in elderly subjects?
Observational (n=4,076)
Yes
How does systolic blood pressure relate to cognitive function in elderly subjects?
Effect estimate: B = -0.047 per 10 mmHg increase (MMSE ≥24)
p-value: p=0.002
The relationship between systolic blood pressure and cognitive function is biphasic, with higher BP associated with worse cognition in those with preserved cognitive function, but lower BP associated with worse cognition in those with impaired cognitive function.
No immediate BP target changes indicated; leaves open whether SBP-cognition links differ by cognitive status.
BACKGROUND: Although an elevated systolic blood pressure (SBP) is associated with cognitive dysfunction, BP may decrease with advanced cognitive dysfunction; therefore, we attempted to identify the turning point in the relationship between cognitive function and SBP in elderly subjects. METHODS: In pooled datasets of general populations and outpatient clinics (age>65 years), in which the risk of frailty or cognitive dysfunction was assessed (N = 4076), the relationship between SBP and the Mini Mental State Examination (MMSE) score was examined. RESULTS: Mean age was 72.5 ± 6.2 years (male 45.1%), and SBP was 133.0 ± 19.5 mmHg. In an analysis of locally weighted scatter plot smoothing, the relationship between SBP and MMSE scores changed at an MMSE score of 24 points. In subjects with preserved cognitive function (MMSE ≥24 points), MMSE scores decreased with increases in SBP (B = -0.047 per 10 mmHg increase, P = 0.002) after adjustments for age, sex, body mass index, alcohol habit, smoking status, diabetes, a history of stroke, and the geriatric nutritional index; however, in subjects with reduced cognitive function (MMSE<24 points), decreases in the MMSE score were associated with reductions in SBP (B = 1.178 per 1 point decrease in the MMSE score, P = 0.002). CONCLUSION: The relationship between SBP and cognitive function changed at a MMSE score of approximately 24 points (mild to moderate cognitive dysfunction). In patients with preserved MMSE, higher BP values were associated with a reduction of cognitive function, but this was not a case for those with impaired MMSE.
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Ishikawa et al. (2021) conducted an observational in Cognitive dysfunction (n=4,076). Systolic blood pressure was evaluated on Mini Mental State Examination (MMSE) score (B = -0.047 per 10 mmHg increase (MMSE ≥24), p=0.002). Higher systolic blood pressure was associated with lower cognitive function in subjects with preserved MMSE (P=0.002), whereas the relationship was reversed in those with impaired MMSE (P=0.002).
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