|Title||Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals.|
|Publication Type||Journal Article|
|Year of Publication||2020|
|Authors||Levine DA, Gross AL, Briceño EM, Tilton N, Kabeto MU, Hingtgen SM, Giordani BJ, Sussman JB, Hayward RA, Burke JF, Elkind MSV, Manly JJ, Moran AE, Kulick ER, Gottesman RF, Walker KA, Yano Y, Gaskin DJ, Sidney S, Yaffe K, Sacco RL, Wright CB, Roger VL, Allen NBai|
|Secondary Authors||Galecki AT|
|Date Published||2020 Jul 01|
Importance: Black individuals are more likely than white individuals to develop dementia. Whether higher blood pressure (BP) levels in black individuals explain differences between black and white individuals in dementia risk is uncertain.
Objective: To determine whether cumulative BP levels explain racial differences in cognitive decline.
Design, Setting, and Participants: Individual participant data from 5 cohorts (January 1971 to December 2017) were pooled from the Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Outcomes were standardized as t scores (mean [SD], 50 ); a 1-point difference represented a 0.1-SD difference in cognition. The median (interquartile range) follow-up was 12.4 (5.9-21.0) years. Analysis began September 2018.
Main Outcomes and Measures: The primary outcome was change in global cognition, and secondary outcomes were change in memory and executive function.
Exposures: Race (black vs white).
Results: Among 34 349 participants, 19 378 individuals who were free of stroke and dementia and had longitudinal BP, cognitive, and covariate data were included in the analysis. The mean (SD) age at first cognitive assessment was 59.8 (10.4) years and ranged from 5 to 95 years. Of 19 378 individuals, 10 724 (55.3%) were female and 15 526 (80.1%) were white. Compared with white individuals, black individuals had significantly faster declines in global cognition (-0.03 points per year faster [95% CI, -0.05 to -0.01]; P = .004) and memory (-0.08 points per year faster [95% CI, -0.11 to -0.06]; P
Conclusions and Relevance: These results suggest that black individuals' higher cumulative BP levels may contribute to racial differences in later-life cognitive decline.
|Alternate Journal||JAMA Neurol|
|PubMed Central ID||PMC7154952|
|Grant List||P30 AG066507 / AG / NIA NIH HHS / United States |
R01 NS102715 / NS / NINDS NIH HHS / United States
RF1 AG054443 / AG / NIA NIH HHS / United States