Year: 2019
Type: article
Study design: Observational Study
Abstract: Prior studies suggest that hypertension in midlife increases the risk of late-life cognitive impairment and dementia. We examined whether cognitive reserve (CR) modifies the association between baseline hypertension and cognitive decline among individuals who were primarily middle aged and cognitively normal at baseline (N=273, mean baseline age = 57 years, mean follow-up time = 13.7 years, max follow-up time = 20.7 years). The presence of hypertension was based on self-report and use of anti-hypertensive medications. CR was indexed with a composite score combining education with reading and vocabulary scores. Cognition was measured annually with a composite score previously shown to predict progression from normal cognition to Mild Cognitive Impairment (MCI), and based on the following tests: Boston Naming, Paired Associates Immediate Recall, Logical Memory Delayed Recall, and Digit-Symbol Substitution. Mixed linear regressions showed that higher CR scores were associated with higher baseline cognitive performance, whereas presence of hypertension was associated with more negative cognitive trajectories. There was also an interaction between presence of hypertension, CR, and time such that the negative impact of hypertension on cognitive trajectories was reduced among those with higher CR. This suggests that CR or factors associated with CR may mitigate mid-life hypertension effects, either directly via their impact on cognition or via differences in management and control of hypertension.
Source: Alzheimer s & Dementia
Institution: Johns Hopkins University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2980493775