Dementia Risk: Fluctuating Blood Pressure in Seniors

According to a new study conducted by Australian researchers, fluctuating blood pressure can raise the risk of dementia and vascular disorders in older adults.
Short blood pressure (BP) variations within 24 hours and over multiple days or weeks are associated with decreased cognition, according to researchers from the University of South Australia (UniSA).

Higher systolic blood pressure changes (the top number that measures the pressure in arteries when a heart beats) are also connected with artery hardening, which is linked to heart disease.

Lead author Daria Gutteridge, a Ph.D. candidate based in UniSA’s Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), says it’s well-known that high blood pressure is a risk factor for dementia. Still, little attention is paid to fluctuating blood pressure.

“Clinical treatments focus on hypertension, while ignoring the variability of blood pressure,” Gutteridge says.

“Blood pressure can fluctuate across different time frames – short and long – and this appears to heighten the risk of dementia and blood vessel health.”

UniSA researchers recruited 70 healthy older persons aged 60-80 years with no symptoms of dementia or cognitive impairment to assist them investigate the mechanisms that link BP variations with dementia.

Their blood pressure was monitored, they took a cognitive exam, and transcranial Doppler sonography and pulse wave analysis were used to determine arterial stiffness in the brain and arteries.

“We found that higher blood pressure variability within a day and across days was linked with reduced cognitive performance. We also found that higher blood pressure variations within the systolic BP were correlated with higher blood vessel stiffness in the arteries.

“These results indicate that the different types of BP variability likely reflect different underlying biological mechanisms, and that systolic and diastolic blood pressure variation are both important for cognitive functioning in older adults.”

According to the researchers, the associations were seen in older persons who did not have clinically relevant cognitive impairment, implying that blood pressure variability could be used as an early clinical indication or therapy target for cognitive impairment.

For more information: Cross-sectional Associations between Short and Mid-term Blood Pressure Variability, Cognition, and Vascular Stiffness in Older Adults.” Cerebral Circulation – Cognition and Behavior

https://doi.org/10.1016/j.cccb.2023.100181