title: The effect of age on the association between blood pressure and cognitive function later in life.
abstract: OBJECTIVE
  To determine the prospective relationship between blood pressure (BP) and cognitive function across a wide age range.
  
  
  METHODS
  Prospective population-based cohort study.
  
  
  METHODS
  The Rotterdam Study and the Leiden 85-plus Study.
  
  
  METHODS
  Three thousand seventy-eight men and women, initial age 55 to 84 from the Rotterdam Study and 276 men and women, initial age 85, from the Leiden 85-plus Study.
  
  
  METHODS
  Systolic BP (SBP) and diastolic BP (DBP) were measured at baseline, cognitive function was assessed at the end of follow-up using a dedicated neuropsychological test battery. The association between baseline BP levels and cognitive function later in life was assessed in 10-year age groups in the Rotterdam Study and in 85-year-olds of the Leiden 85-plus Study.
  
  
  RESULTS
  In the youngest participants (<65), SBP and DBP were not associated with cognitive function 11 years later. For persons aged 65 to 74, higher baseline SBP and DBP were related to worse cognitive function 11 years later. In contrast, in older age (> or = 75), higher SBP and DBP seemed to be related to better cognitive function at the end of follow-up. This effect appeared strongest in the highest age group (aged 85).
  
  
  CONCLUSIONS
  High BP was associated with greater risk of cognitive impairment in persons younger than 75 but with better cognitive function in older persons. Age-specific guidelines for BP management are needed, because the current directive that "lower is better" may not apply to BP levels in the very old.
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: Sjoerd M
authors.initials: SM
authors.lastname: Euser
authors.forename: Thomas
authors.initials: T
authors.lastname: van Bemmel
authors.forename: Miranda T
authors.initials: MT
authors.lastname: Schram
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
authors.forename: Monique M B
authors.initials: MM
authors.lastname: Breteler
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests; D011446:Prospective Studies