George H shakes his head as he relates leaving his briefcase
in local restaurants three times in one week. The 67-year-old
Edmontonian is more bemused than concerned. Still, for
many folks the mental creaking of gears often associated
with aging can be a source of bewilderment and even trauma.
A study published in the March edition of Hypertension
shows that this decline in cognitive function may be due
to changes in blood pressure (BP) as well as demographic
and lifestyle factors.
The Hypertension paper was
based on information gathered from The Baltimore Longitudinal
Study of Aging. Researchers Dr Shari Waldstein of the
University of Maryland in Baltimore and her colleagues
recruited 847 people — 503 men and 344 women —
for the study. Subjects' BPs were monitored and all
participants completed a series of cognitive function
tests seven times over an 11-year period. The cognitive
function tests assessed "verbal and nonverbal memory,
attention, perceptuo-motor speed, executive functions
and confrontation naming," explain the researchers in
their study. Confrontation naming tasks require subjects
to name objects or activities represented by pictures.
BP-BRAIN
connection
The resulting data was crunched using regression models
that adjusted for demographic and lifestyle factors
including age, educational level, gender, use and extent
of use of tobacco and alcohol, depression, and the use
of anti-hypertension drugs. The researchers discovered
that elevated BP and changes in cognitive function over
time were linked in several ways.
For instance, increased systolic
BP was associated with a decline in the efficiency of
nonverbal memory and confrontation naming. Although
this association was not linear with age, it was definitely
evident in folks over 80 with elevated BP.
High and low diastolic BPs were
linked to poor executive function and confrontation
naming in people with a lower educational level, poor
motor speed and confrontation naming in folks not taking
any anti-hypertensive meds, and less than stellar executive
function in older folks.
"Cross-sectional and longitudinal
relations of blood pressure to cognition function are
predominantly nonlinear and moderated by age, education
and antihypertensive medications," conclude Dr Waldstein
and her colleagues.
Physicians with patients that match
the demographic hot spots would do well to ensure that
BP monitoring is a staple of the office visit. "Careful
monitoring and treatment of both high and low blood
pressure levels may be critical to the preservation
of cognitive function," advise the authors in their
study.
Hypertension Mar, 2005;45:374-9
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