Document Detail

Dementia and lower blood pressure in Latin America, India, and China: a 10/66 cross-cohort study.
MedLine Citation:
PMID:  23771488     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the relationship between dementia and blood pressure (BP) in 8 low- and middle-income countries.
METHODS: In identical cross-sectional surveys of older adults (aged 65 years and older) conducted in Cuba, Dominican Republic, Peru, Venezuela, Mexico, Puerto Rico, China, and India (n = 15,746), we measured systolic and diastolic BP and used the 10/66 prevalidated algorithms to adjudicate dementia diagnosis and quantify dementia severity (Clinical Dementia Rating [CDR]).
RESULTS: BP levels, dementia prevalence, and participants' sociodemographic and health characteristics varied across sites. In fixed-effect meta-analyses of site-specific linear regression coefficients adjusted for potential confounders, dementia and CDR were cross-sectionally associated with lower systolic BP (β = -1.7, 95% confidence interval [CI]: -2.8, -0.6; and β = -1.1, 95% CI: -1.5, -0.7) and diastolic BP (β = -0.4, 95% CI: -1.1, 0.2; and β = -0.4, 95% CI: -0.7, -0.2). Associations were heterogeneous across sites for both dementia (I(2) < 47%) and CDR (I(2) < 75%), and were strongest in Cuba, where prevalence of hypertension was highest. Results were robust to alternative model specifications that accounted for hypertensive status, antihypertensive treatment, and leanness (i.e., smaller waist circumference).
CONCLUSION: The association between dementia and lower BP was heterogeneous across geographically diverse samples, strongest where prevalent hypertension was highest (in Cuba), and relatively small compared with that found in Western settings. Both the mechanisms and the extent to which different levels of lifetime hypertensive disease explain this heterogeneity remain uncertain. However, because rapid increments in both dementia and hypertension are predicted in low- and middle-income countries, closer monitoring is warranted.
Emiliano Albanese; Flavia L Lombardo; Martin J Prince; Robert Stewart
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2013-06-14
Journal Detail:
Title:  Neurology     Volume:  81     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-16     Completed Date:  2013-09-23     Revised Date:  2014-01-17    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  228-35     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Blood Pressure
China / epidemiology
Cohort Studies
Cross-Sectional Studies
Dementia / epidemiology*
Hypertension / epidemiology*
India / epidemiology
Latin America / epidemiology
Middle Aged
Severity of Illness Index
Grant Support
GR066133//Wellcome Trust

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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