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Age modifies the relation between intraindividual measurement-to-measurement variation in blood pressure and cognitive function: the Maine-Syracuse Study

Dore, Gregory, A.a; Elias, Merrill, F.b; Crichton, Georgina, E.c; Robbins, Michael, A.b

doi: 10.1097/HJH.0000000000001510

Background: There is evidence to suggest that intraindividual variability in blood pressure (BP IIV) may be superior to mean BP for predicting cognitive function, taken from both within a single visit and between-visits. BP IIV increases with age in studies of persons middle-aged and older. The aim was therefore to investigate age by BP IIV (SBP and DBP) interactions with regard to cognitive functioning while considering medication class and polypharmacy, which may also affect BP IIV with advancing age.

Method and results: Cross-sectional analyses were performed on 980 community-dwelling individuals from the Maine-Syracuse Longitudinal Study. Automated BP measures were taken 15 times (five times each in sitting, reclining, and standing positions). Cognitive function was assessed using a thorough neuropsychological test battery following the BP assessment. A significant age by BP IIV interaction was observed. For individuals aged over age 60 years, IIV in SBP and DBP was inversely associated with Global Composite, Scanning and Tracking, and the Similarities test. IIV in SBP was additionally associated with Verbal Memory and the Mini-Mental State Examination. DBP IIV was additionally related to the Visual-Spatial Memory and Organization composite. There were no significant associations between BP IIV and cognitive function in those aged less than 60 years.

Conclusion: BP IIV is an important predictor of cognition with advancing age.

aBehavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH Baltimore, Baltimore, Maryland

bDepartment of Psychology and Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, Maine, USA

cAlliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia

Correspondence to Georgina E. Crichton, Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide 5001, SA, Australia. Tel: +61 434869665; fax: +61 884311101; e-mail:

Abbreviations: ACE, angiotensin-converting enzyme; BP IIV, intraindividual variability in blood pressure; BP, blood pressure; CA, calcium; CVD, cardiovascular disease; HTN, hypertension; M, mean; MMSE, Min-Mental State Examination; MSLS, Maine-Syracuse Longitudinal Study; NINCDS–ADRDA, National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association; Rx, treatment; SE, standard error

Received 14 January, 2017

Revised 30 June, 2017

Accepted 11 July, 2017

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