The association of blood pressure with physical frailty and cognitive function in community-dwelling septuagenarians, octogenarians, and nonagenarians: the SONIC study
The association of blood pressure with physical frailty and cognitive function in community-dwelling septuagenarians, octogenarians, and nonagenarians: the SONIC study
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DOI：
10.1038/s41440-020-0499-9
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发表时间：
2020-07-08
影响因子：
5.4
通讯作者：
Rakugi, Hiromi
中科院分区：
文献类型：
--
作者：
Kabayama, Mai;Kamide, Kei;Rakugi, Hiromi
我们调查了居住在社区的日本老年人的收缩压(SBP)水平与身体虚弱和认知功能的关系。以百岁老人调查为基线，对70+/-1(n=1000)、80+/-1(n=978)和90+/-1(n=272)老年人进行横断面分析。病历和药物是通过医疗专业人员进行的访谈收集的。现场检测血压、握力、步速和认知功能。采用趋势分析和多元回归分析确定SBP水平与身体虚弱和认知功能的关系。主要的发现是，SBP与身体虚弱和认知功能的关联取决于年龄、身体和认知功能以及抗高血压药物的使用等特征。只有在服用降压药的80岁老年人中，较低的SBP水平才与较高的身体虚弱患病率相关。在70岁的老年人中，发现较高的SBP与较低的认知功能之间存在显著的关联，而在90岁的老年人中，则发现相反的情况。在80岁的参与者中或在所有年龄段的参与者中没有发现相关性。我们的研究发现，SBP和老年综合征之间存在反向关联，这表明老年患者的治疗必须个体化，以预防老年综合征。
We investigated the association of systolic blood pressure (SBP) level with physical frailty and cognitive function in community-dwelling older Japanese. Using the 'Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians' survey as the baseline, we performed a cross-sectional analysis of people aged 70 +/- 1 (n = 1000), 80 +/- 1 (n = 978), and 90 +/- 1 (n = 272) years. Medical histories and medications were collected via interviews conducted by medical professionals. Blood pressure (BP), grip strength, gait speed, and cognitive function were examined on site. Trend analysis and multiple regression analysis were used to determine the association of the SBP level with physical frailty and cognitive function. The principal finding was that the association of SBP with physical frailty and cognitive function varied depending on characteristics such as age, physical and cognitive function, and antihypertensive medication use. A lower SBP level was associated with a higher prevalence of physical frailty only among 80-year-olds who were on antihypertensive medication. A significant association was found between higher SBP and lower cognitive function among 70-year-olds, while among 90-year-olds, the opposite was found. No association was found among participants who were 80 years old or among participants of all ages without antihypertensive medication. Our finding that an inverted association between SBP and geriatric syndrome exists suggests that the treatment of older patients must be individualized to prevent geriatric syndrome.