Age- and Functional Status-Dependent Association Between Blood Pressure and Cognition: The Milan Geriatrics 75+ Cohort Study.
OBJECTIVE
To evaluate whether the relationship between blood pressure (BP) measures and cognitive function is different according to age and functional status in older outpatients.


METHODS
Cross-sectional.


METHODS
Outpatient hospital-based Milan Geriatrics 75+ Cohort Study.


METHODS
Individuals aged 75 and older (N = 1,540).


METHODS
Blood pressure, Mini-Mental State Examination (MMSE), basic activities of daily living (ADLs), and instrumental activities of daily living (IADLs) were assessed. Associations between BP measures and MMSE score were first analyzed in the total population using linear regression models and were then further examined according to strata of age, ADLs, and IADLs. All analyses were adjusted for sociodemographic factors and presence of comorbidities.


RESULTS
In the total population, higher systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), and mean arterial pressure (MAP) were all associated with higher MMSE score (all P < .05). Each 10-mmHg higher SBP and DBP was associated with a 0.26- and 0.55-point higher MMSE score, respectively. The associations between MMSE score and SBP, DBP, and MAP differed materially according to strata of age and functioning and were most pronounced in those aged 85 and older, with ADL impairments, and with IADL impairments.


CONCLUSIONS
Higher BP is associated with better cognitive function in the oldest old and in those with impaired functional status.
Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.|Department ofDepartment of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
Giulia
G
Ogliari
Department ofDepartment of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.|Department ofDepartment of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
Behnam
B
Sabayan
Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.|Geriatric Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
Daniela
D
Mari
Geriatric Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
Paolo D
PD
Rossi
Geriatric Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
Tiziano A
TA
Lucchi
Department ofDepartment of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
Anton J M
AJ
de Craen
Department ofDepartment of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.|Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Rudi G J
RG
Westendorp
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination; D003071:Cognition; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male
aging; blood pressure; cognitive function; cohort study; functional status