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Cognitive Dysfunction and Greater Visit-to-Visit Systolic Blood Pressure Variability

Authors

  • Noam U. Epstein MD, MS,

    Corresponding author
    1. Department of Neurology, Hines Veterans Affairs Medical Center, Hines, Illinois
    • Address correspondence to Noam U. Epstein, Department of Neurology, Hines VA Medical Center, 5000 South 5th Avenue, Hines, IL 60141. E-mail: nue2you@gmail.com

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  • Kathleen A. Lane MS,

    1. Division of Biostatistics, School of Medicine, Indiana University, Indianapolis, Indiana
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  • Martin R. Farlow MD,

    1. Indiana Alzheimer Disease Center, School of Medicine, Indiana University, Indianapolis, Indiana
    2. Department of Neurology, School of Medicine, Indiana University, Indianapolis, Indiana
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  • Shannon L. Risacher PhD,

    1. Department of Radiology and Imaging Sciences, Center for Neuroimaging, School of Medicine, Indiana University, Indianapolis, Indiana
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  • Andrew J. Saykin PsyD,

    1. Indiana Alzheimer Disease Center, School of Medicine, Indiana University, Indianapolis, Indiana
    2. Department of Radiology and Imaging Sciences, Center for Neuroimaging, School of Medicine, Indiana University, Indianapolis, Indiana
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  • Sujuan Gao PhD,

    1. Division of Biostatistics, School of Medicine, Indiana University, Indianapolis, Indiana
    2. Indiana Alzheimer Disease Center, School of Medicine, Indiana University, Indianapolis, Indiana
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  • and for The Alzheimer's Disease Neuroimaging Initiative


Abstract

Objectives

To determine whether variability in blood pressure (BP) is negatively associated with performance on cognitive testing.

Design

Multinational, longitudinal, observational cohort study.

Setting

The Alzheimer's Disease Neuroimaging Initiative study.

Participants

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

Measurements

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 (< .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).

Conclusion

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.

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