title: High blood pressure and resilience to physical and cognitive decline in the oldest old: the Leiden 85-plus Study.
abstract: OBJECTIVE
  To evaluate the association between various blood pressure (BP) measures at age 85 and future decline in physical and cognitive function the oldest old.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  The population-based Leiden 85-plus Study.
  
  
  METHODS
  Five hundred seventy-two 85-year-old community-dwelling individuals.
  
  
  METHODS
  BP was measured at age 85 during home visits. Activities of daily living (ADLs) and Mini-Mental State Examination (MMSE) were assessed at age 85 and annually thereafter up to age 90. On average, participants were followed for 3.2 years. Cross-sectional and longitudinal analyses were performed using linear regression models using systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP) as the determinants. All analyses were adjusted for sociodemographic and cardiovascular factors.
  
  
  RESULTS
  At age 85, higher SBP and PP were associated with lower ADL disability scores (both P = .01). Similarly, higher SBP, DBP, and MAP were associated with higher MMSE scores (all P < .05). From age 85 onward, higher SBP (P < .001), MAP (P = .01), and PP (P = .003) at age 85 were associated with lower annual increases in ADL disability scores. Likewise, higher SBP (P = .03) and PP (P = .008) at age 85 were associated with lower annual declines in MMSE scores. Additional analyses showed that the association between high BP and lower annual decline in MMSE score was most pronounced in participants with high ADL disability.
  
  
  CONCLUSIONS
  In the oldest old, higher SBP and PP are associated with resilience to physical and cognitive decline, especially in individuals with pre-existing physical disability.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands. b.sabayan@lumc.nl
authors.forename: Behnam
authors.initials: B
authors.lastname: Sabayan
authors.forename: Anna M
authors.initials: AM
authors.lastname: Oleksik
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Maier
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: Rosalinde K E
authors.initials: RK
authors.lastname: Poortvliet
authors.forename: Wouter
authors.initials: W
authors.lastname: de Ruijter
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies