Cross-sectional associations between short and mid-term blood pressure variability, cognition, and vascular stiffness in older adults

D.S. Gutteridge; P.J. Tully; A.E. Smith; T. Loetscher; H.A. Keage

Cerebral Circulation - Cognition and Behavior (Jan 2023)

Cross-sectional associations between short and mid-term blood pressure variability, cognition, and vascular stiffness in older adults

D.S. Gutteridge,
P.J. Tully,
A.E. Smith,
T. Loetscher,
H.A. Keage

Affiliations

D.S. Gutteridge: Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, SA, Australia; Corresponding author at: Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, GPO Box 2471, Adelaide 5000, SA, Australia.
P.J. Tully: Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, NSW, Australia
A.E. Smith: Alliance for Research in Exercise Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
T. Loetscher: Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, SA, Australia
H.A. Keage: Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, SA, Australia

Journal volume & issue: Vol. 5
p. 100181

Abstract

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ABSTRACT: Background: High blood pressure variability (BPV), particularly in older age, appears to be an independent risk factor for incident dementia. The current study aimed to investigate the association between different BPV measures (short- and mid-term BPV including circadian patterns) and cognitive functioning as well as vascular stiffness measures to better understand the role that BPV plays in cognitive impairment. Methods: 70 older adults (60–80-year-olds) without dementia completed a cognitive test battery and had their blood pressure (BP) assessed via a 24-hour ambulatory BP monitor (divided into sleep and wake for short-term BPV) and 4-day morning and evening home-based BP monitor (for day-to-day BPV). Arterial stiffness was evaluated via pulse wave analysis and pulse wave velocity (PWV) and cerebrovascular pulsatility was assessed via transcranial doppler sonography of the middle cerebral arteries. Results: High systolic as well as diastolic short- and mid-term BPV were associated with poorer cognitive functioning, independent of the mean BP. Higher short-term BPV was associated with poorer attention and psychomotor speed, whilst day-to-day BPV was negatively linked with executive functioning. Circadian BP patterns (dipping and morning BP surge) showed no significant relationships with cognition after adjusting for covariates. Higher systolic short-term BPV was associated with higher arterial stiffness (PWV) and higher diastolic day-to-day BPV was linked with lower arterial stiffness. No significant associations between BPV measures and cerebrovascular pulsatility were present. Conclusion: High BPV, independently of the mean BP, is associated with lower cognitive performance and increased arterial stiffness in older adults without clinically-relevant cognitive impairment. This highlights the role of systolic and diastolic BPV as a potential early clinical marker for cognitive impairment.

Published in Cerebral Circulation - Cognition and Behavior

ISSN: 2666-2450 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/cerebral-circulation-cognition-and-behavior

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