Cognitive dysfunction and greater visit-to-visit systolic blood pressure variability.
OBJECTIVE
To determine whether variability in blood pressure (BP) is negatively associated with performance on cognitive testing.


METHODS
Multinational, longitudinal, observational cohort study.


METHODS
The Alzheimer's Disease Neuroimaging Initiative study.


METHODS
Individuals with a screening diagnosis of mild cognitive impairment or normal cognition (N=626).


METHODS
Mean, variance, and maximum BP were calculated based on measures collected from screening to 36 months. Analysis of covariance models were used to determine the association between BP measures and cognitive scores at 36 months after adjusting for covariates.


RESULTS
Greater variability in systolic (P<.05) but not diastolic (P>.18) BP was associated with worse global (Modified Alzheimer's Disease Assessment Scale Cognitive Component and Clinical Dementia Rating sum of boxes) and executive (Trail-Making Test Part B, Animal Fluency, and Vegetable Fluency) function and episodic memory (Rey Auditory Verbal Learning Test Total Score).


CONCLUSIONS
There is a clinically significant association between greater systolic BP variability and greater cognitive dysfunction. These results should be verified in other well-characterized cohorts, and the neuroanatomical pathophysiology underlying the observed greater cognitive impairment should be further explored.
Department of Neurology, Hines Veterans Affairs Medical Center, Hines, Illinois.
Noam U
NU
Epstein
Division of Biostatistics, School of Medicine, Indiana University, Indianapolis, Indiana.
Kathleen A
KA
Lane
Indiana Alzheimer Disease Center, School of Medicine, Indiana University, Indianapolis, Indiana.|Department of Neurology, School of Medicine, Indiana University, Indianapolis, Indiana.
Martin R
MR
Farlow
Department of Radiology and Imaging Sciences, Center for Neuroimaging, School of Medicine, Indiana University, Indianapolis, Indiana.
Shannon L
SL
Risacher
Indiana Alzheimer Disease Center, School of Medicine, Indiana University, Indianapolis, Indiana.|Department of Radiology and Imaging Sciences, Center for Neuroimaging, School of Medicine, Indiana University, Indianapolis, Indiana.
Andrew J
AJ
Saykin
Division of Biostatistics, School of Medicine, Indiana University, Indianapolis, Indiana.|Indiana Alzheimer Disease Center, School of Medicine, Indiana University, Indianapolis, Indiana.
Sujuan
S
Gao
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013599:Systole / Q000502:physiology