The effect of age on the association between blood pressure and cognitive function later in life.
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.
Euser
Sjoerd M
SM
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
van Bemmel
Thomas
T
Schram
Miranda T
MT
Gussekloo
Jacobijn
J
Hofman
Albert
A
Westendorp
Rudi G J
RG
Breteler
Monique M B
MM
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