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High Blood Pressure Hinders Memory in Old Age
Many senior citizens with hypertension will
experience significant cognitive declines
Dec. 5, 2005 - People with high blood pressure and
their doctors have a new reason to work at controlling this common but
high-risk condition: As patients get older, they might otherwise have
worse-than-normal problems with short-term memory and verbal ability.
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New research shows that uncontrolled hypertension
puts people at higher risk for sharper drops in these cognitive
functions than does blood pressure that's normal due to diet, exercise
and/or medication. The study appears in the current November issue of
Neuropsychology, which is published by the American Psychological
Association (APA).
Because blood pressure typically increases with
age, hypertension affects 60 percent of adults age 60 and older.
However, this "silent killer" often goes undetected
or inadequately treated, leaving nearly 40 percent of older hypertensive
people with continued high readings -- even with treatment.
As a result, the findings suggest that a
substantial number of older people with uncontrolled hypertension will
experience significant cognitive declines, especially because with age,
hypertension becomes more common and harder to control.
Researchers at the Veterans Affairs (VA) Boston
Healthcare System, Harvard Medical School and the Boston University
School of Public Health looked at a subset of men in the VA Normative
Aging Study, a longitudinal study that started in 1963 and added
neuropsychological tests in 1993.
In this smaller cross-sectional study, 357 men from
the larger sample averaged 67 years of age, lived in the community,
didn't have dementia or other serious medical problems, and showed
stable blood pressure over a three-year interval. Hypertension was
defined as measuring 140/90 and higher.
Co-authors Christopher Brady, PhD, Avron Spiro III,
PhD, and J. Michael Gaziano, MD, MPH, found that the older the men, the
predictably lower their overall neuropsychological performance. However,
older men in the sample with uncontrolled hypertension did significantly
worse on specific tests of verbal fluency (generating words in a given
category) and immediate recall of a word list (short-term memory).
The uncontrolled hypertensives' decrements on
fluency were 2.4 times as great as for those with normal pressure; their
decrement with immediate recall was 1.3 times as great. That means by
the age of 80, men with uncontrolled hypertension could generate seven
fewer words in a given category, and recall about one and a half fewer
words on average, than the other 80-year-old men in the study.
"The findings suggest that uncontrolled
hypertension produces specific cognitive deficits beyond those
attributable to age alone," the researchers report. They also note that
their findings are consistent with other studies that suggest that anti-
hypertensive drugs do not hurt cognition, given that the men with
controlled hypertension who used them in this study did as well as men
who had naturally normal blood pressure. The researchers speculate that
high blood pressure somehow exacerbates the normal effects of age on the
frontal lobes, making it even harder to quickly retrieve information
such as words.
The authors raise the possibility that the actual
proportion of cognitive problems among older people with uncontrolled
hypertension in the general population may actually be larger than seen
in the study, because this sample used healthy men with no other health
problems. Uncontrolled hypertension also is known to raise the risk of
vascular dementia, the second most common form of serious cognitive
impairment after Alzheimer's disease.
Article: Christopher B. Brady, PhD, Veterans
Affairs Boston Healthcare System and Harvard Medical School; Avron Spiro
III, PhD, Veterans Affairs Boston Healthcare System and Boston
University School of Public Health; J. Michael Gaziano, MD, MPH,
Veterans Affairs Boston Healthcare System and Harvard Medical School;
"Effects of Age and Hypertension Status on Cognition: The Veterans
Affairs Normative Aging Study;" Neuropsychology, Vol. 19, No. 6.
About Source
The American Psychological Association (APA), in
Washington, DC, is the largest scientific and professional organization
representing psychology in the United States and is the world's largest
association of psychologists. APA's membership includes more than
150,000 researchers, educators, clinicians, consultants and students.
Through its divisions in 53 subfields of psychology and affiliations
with 60 state, territorial and Canadian provincial associations, APA
works to advance psychology as a science, as a profession and as a means
of promoting human welfare.
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