BACKGROUND AND PURPOSE: The efficacy of treating older persons for hypertension remains controversial. Although clinical trials suggest no short-term harm, or some benefits, there are little data on the effect on cognitive function of long-term antihypertensive treatment. We evaluated the risk of dementia and cognitive decline associated with duration of antihypertensive treatment. METHODS: Data are from the Honolulu Asia Aging Study on Japanese American men followed since 1965. The subjects included in this analysis were hypertensive from midlife and dementia-free in 1991 (mean age 76.7 years). In 1991, 1994 and 1997, global cognitive function was assessed with the Cognitive Abilities Screening Instrument (CASI) and dementia by a standardized examination using international criteria. The sample was grouped by treatment duration (never-treated hypertensives (NTH), <5 years, 5 to 12 years, >12 years). Normotensive subjects up to 1991 were included in the analysis as a control group. RESULTS: For each additional year of treatment there was a reduction in the risk of incident dementia (hazard ratio [HR]=0.94, 95% CI, 0.89 to 0.99). The risk for dementia in subjects with >12 years of treatment was lower compared to NTH (HR for dementia=0.40; 95% CI, 0.22 to 0.75 and for Alzheimer disease HR=0.35; 95% CI, 0.16 to 0.78) and was similar to the normotensives. Nondemented subjects with 5 to 12 years of treatment had lower yearly CASI decline compared to NTH. CONCLUSIONS: Results suggest that in hypertensive men, the duration of the antihypertensive treatment is associated with a reduced risk for dementia and cognitive decline.
BACKGROUND AND PURPOSE: The efficacy of treating older persons for hypertension remains controversial. Although clinical trials suggest no short-term harm, or some benefits, there are little data on the effect on cognitive function of long-term antihypertensive treatment. We evaluated the risk of dementia and cognitive decline associated with duration of antihypertensive treatment. METHODS: Data are from the Honolulu Asia Aging Study on Japanese American men followed since 1965. The subjects included in this analysis were hypertensive from midlife and dementia-free in 1991 (mean age 76.7 years). In 1991, 1994 and 1997, global cognitive function was assessed with the Cognitive Abilities Screening Instrument (CASI) and dementia by a standardized examination using international criteria. The sample was grouped by treatment duration (never-treated hypertensives (NTH), <5 years, 5 to 12 years, >12 years). Normotensive subjects up to 1991 were included in the analysis as a control group. RESULTS: For each additional year of treatment there was a reduction in the risk of incident dementia (hazard ratio [HR]=0.94, 95% CI, 0.89 to 0.99). The risk for dementia in subjects with >12 years of treatment was lower compared to NTH (HR for dementia=0.40; 95% CI, 0.22 to 0.75 and for Alzheimer disease HR=0.35; 95% CI, 0.16 to 0.78) and was similar to the normotensives. Nondemented subjects with 5 to 12 years of treatment had lower yearly CASI decline compared to NTH. CONCLUSIONS: Results suggest that in hypertensivemen, the duration of the antihypertensive treatment is associated with a reduced risk for dementia and cognitive decline.
Authors: Amanda Kelly; Matthew Calamia; Andrey Koval; Graciela Muniz Terrera; Andrea M Piccinin; Sean Clouston; Linda B Hassing; David A Bennett; Boo Johansson; Scott M Hofer Journal: Psychol Aging Date: 2016-02-25
Authors: Jessica B S Langbaum; Kewei Chen; Lenore J Launer; Adam S Fleisher; Wendy Lee; Xiaofen Liu; Hillary D Protas; Stephanie A Reeder; Daniel Bandy; Meixiang Yu; Richard J Caselli; Eric M Reiman Journal: Neurobiol Aging Date: 2011-08-06 Impact factor: 4.673
Authors: Ashley J Szabo; Michael L Alosco; Lindsay A Miller; John E McGeary; Athena Poppas; Ronald A Cohen; John Gunstad Journal: Psychogeriatrics Date: 2013-10-28 Impact factor: 2.440