Systolic blood pressure tracking over 25 to 30 years and cognitive performance in older adults
Systolic blood pressure tracking over 25 to 30 years and cognitive performance in older adults
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DOI：
10.1161/01.str.29.11.2334
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发表时间：
1998-11-01
期刊：
影响因子：
8.3
通讯作者：
Larue, A
中科院分区：
文献类型：
--
作者：
Swan, GE;Carmelli, D;Larue, A
30-确定收缩压（SBP）在30年间隔内的个体变化与老年人不同的神经心理学结果相关的程度。方法-来自西方协作组研究的717名幸存者，该研究是一项心血管危险因素的纵向研究，目前已随访38年。在中年（平均=45岁）和老年（平均=75岁）测量血压，并在随访时进行神经心理学测试。参与者根据SEP的30年变化（增加，减少或“正常”）进行分组。分析重点是“高体感诱发电位追踪器”神经心理学表现的比较（即，那些在整个成年生活中持续SBP大于或等于140 mm Hg的人）和SEP“降低者”的表现，这些人的SEP是稳定的或随着时间以预期的方式改变。而43.8%的老年人SEP升高。在对年龄、教育、抑郁、临床定义的卒中和抗高血压药物的使用进行校正后，并在排除随访时认知功能受损的个体后，高SEP追踪者（5.0%，n=36）在言语学习和记忆的复合测量中的表现始终不如“正常”SEP亚组（P=0.04）。当与“正常”SEP亚组相比，SEP decreasers，5.3%（n=38），表现不太好的快速性能（P=0.03）。结论是有一个相对较小的群体的人在他们的成年生活中保持SEP升高。这些人的语言学习和记忆功能降低的风险增加。还有一组人经历SEP下降，并且有降低心理速度的风险。这2个SEP亚组的描述可能导致SEP对老年人神经行为功能的影响的进一步澄清。
Objective-To determine the extent to which individual changes in systolic blood pressure (SBP) over a 30-year interval are associated with differential neuropsychological outcomes in old age.Methods-Seven hundred seventeen survivors from the Western Collaborative Group Study, a longitudinal study of cardiovascular risk factors now in its 38th year of follow-up, with blood pressures measured in middle age (mean=45 years) and in old age (mean=75 years) and neuropsychological tests administered at follow-up were included in this analysis. Participants were grouped according to 30-year change in SEP (increased, decreased, or "normal"). Analyses focused on comparisons of neuropsychological performance of "high SEP trackers" (ie, those with persistent SBP greater than or equal to 140 mm Hg throughout adult life) and of SEP "decreasers" with the performance of these whose SEP was either stable or changed in an expected way over time.Results-Only 7.5% of participants had elevated SEP in middle age, but 43.8% of participants had elevated SEP in old age. After adjustment for age, education, depression, clinically defined stroke, and use of antihypertensive medications and after exclusion of individuals with impaired cognitive performance at follow-up, high SEP trackers, 5.0% (n=36), performed consistently less well than the "normal" SEP subgroups on a composite measure of verbal learning and memory (P=0.04). When compared with the "normal" SEP subgroup, the SEP decreasers, 5.3% (n=38), performed less well on speeded performance (P=0.03).Conclusions-There is a relatively small group of people who maintain elevated SEP throughout their adult lives. These persons are at increased risk for reduced verbal learning and memory function. There is also a group of individuals who experience a decrease in SEP and who are at risk for decreased psychomotor speed. Delineation of these 2 SEP subgroups may lead to further clarification of the effects of SEP on neurobehavioral function in older adults.