title: Association of late-life changes in blood pressure and cognitive status.
abstract: BACKGROUND
  Disagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to examine whether 4-year changes in systolic and diastolic blood pressure (SBP and DBP) are associated with cognitive status in a representative sample of older men and women.
  
  
  METHODS
  Analysis of longitudinal data from 854 participants of a population-based German sample (aged 60-87 years) was performed with standard cognitive screening and blood pressure measurements. Effects of changes in SBP and DBP (10 mmHg and 5 mmHg respectively as unit of regression effect measure) on cognitive status were evaluated using non-parametric and linear regression modeling.
  
  
  RESULTS
  No clear associations were seen between changes in SBP or in DBP and cognitive scores. Small effects were found after stratification for sex and hypertension awareness. Specifically, larger decreases in SBP were associated with higher cognitive scores in those men aware of their hypertension (10 mmHg decrease in SBP, β = -0.26, 95% CI: -0.51 to -0.02) and men with controlled hypertension (10 mmHg decrease in SBP, β = -0.44, 95% CI: -0.92 to -0.03). Additionally larger increases in DBP were associated with higher cognitive scores in men with controlled hypertension (5 mmHg increase in DBP, β = 0.67, 95% CI: 0.19-1.15). For women aware of their hypertension, larger decreases in DBP were associated with higher cognitive scores (5 mmHg decrease in DBP, β = -0.26; 95%CI: -0.51 to -0.01).
  
  
  CONCLUSIONS
  Changes in blood pressure were only weakly associated with cognitive status. Specifically, decreases in SBP were associated with higher cognitive scores in men aware of their hypertension and especially those that were medically controlled.
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Lacruz
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tiller
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kluttig
authors.affiliation: German Cancer Research Centre, Division of Cancer Epidemiology, Heidelberg, Germany.
authors.forename: Karin H
authors.initials: KH
authors.lastname: Greiser
authors.affiliation: Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Nuding
authors.affiliation: Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Werdan
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Haerting
keywords: Blood pressure; Cognitive status; The elderly