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Nonlinear blood pressure effects on cognition in old age: separating between-person and within-person associations.

Journal article
Authors Valgeir Thorvaldsson
Ingmar Skoog
Scott M. Hofer
Anne Börjesson-Hanson
Svante Östling
Simona Sacuiu
Boo Johansson
Published in Psychology and Aging
Volume 27
Issue 2
Pages 375-383
ISSN 0882-7974
Publication year 2012
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Department of Psychology
Pages 375-383
Language en
Links dx.doi.org/10.1037/a0025631
Keywords blood pressure, cognitive function, longitudinal study, between-person and within-person associations
Subject categories Cognitive science, Public Health, Global Health, Social Medicine and Epidemiology, Gerontology, specializing in Medical and Health Sciences, Psychology

Abstract

Midlife hypertension is associated with increased risk of cognitive impairment in later life. The association between blood pressure (BP) in older ages and cognition is less clear. In this study we provide estimates of between-person and within-person associations of BP and cognition in a population-based sample (N = 382) followed from age 70 across 12 occasions over 30 years. Between-person associations refer to how individual differences in BP relates to individual differences in cognition. Within-person associations refer to how individual and time specific changes in BP relate to variation in cognition. Hierarchical linear models were fitted to data from three cognitive measurements (verbal ability, spatial ability, and perceptual speed) while accounting for demographic and health-related covariates. We found consistent nonlinear between-person associations between diastolic BP (DBP) and cognition, such that both low (<75 mmHg) and high (>95 mmHg) pressure were associated with poorer cognition. Within-person decreases in systolic BP (SBP) and DBP were associated with decreases in perceptual speed. Notably, between-person and within-person estimates did not reveal similar associations, suggesting the need to separate the two effects in the analysis of associations between BP and cognition in old age. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

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