Effect of visit-to-visit blood pressure variability on cognitive and functional decline in mild to moderate Alzheimer's Disease

dc.contributor.authorO'Caoimh, Rónán
dc.contributor.authorGao, Yang
dc.contributor.authorSvendrovski, Anton
dc.contributor.authorIllario, Maddalena
dc.contributor.authorIaccarino, Guido
dc.contributor.authorYavuz, Burcu Balam
dc.contributor.authorKehoe, Patrick Gavin
dc.contributor.authorMolloy, D. William
dc.contributor.funderAtlantic Philanthropiesen
dc.contributor.funderCanadian Institutes of Health Researchen
dc.date.accessioned2019-05-15T10:43:14Z
dc.date.available2019-05-15T10:43:14Z
dc.date.issued2019-04-23
dc.date.updated2019-05-15T10:31:52Z
dc.description.abstractBackground: Visit-to-visit blood pressure (BP) variability (VVV) is increasingly recognized as a marker of cardiovascular risk. Although implicated in cognitive decline, few studies are currently available assessing its effects on established dementia. Objective: To investigate if VVV is associated with one-year rate of decline in measures of cognition and function in patients with mild to moderate Alzheimer’s disease (AD) in the Doxycycline And Rifampicin for Alzheimer’s Disease study. Methods: Patients were included if ≥3 BP readings were available (n = 392). VVV was defined using different approaches including the coefficient of variation (CV) in BP readings between visits. Outcomes included rates of decline in the Standardized Alzheimer’s Disease Assessment Scale–Cognitive Subscale (SADAS-cog), Standardized MMSE, Clinical Dementia Rating Scale, the Quick Mild Cognitive Impairment screen and the Lawton-Brody activities of daily living (ADL) scale. Results: Half of the patients (196/392) had a ≥4-point decline in the SADAS-cog over one-year. Using this cut-off, there were no statistically significant associations between any measures of VVV, for systolic or diastolic BP, with and without adjustment for potential confounders including treatment allocation, history of hypertension and use of anti-hypertensive and cognitive enhancing medications. Multiple regression models examining the association between systolic BP CV by quartile and decline over one-year likewise showed no clinically significant effects, apart from a U-shaped pattern of ADL decline of borderline clinical significance. Conclusions: This observational study does not support recent research showing that VVV predicts cognitive decline in AD. Further studies are needed to clarify its effects on ADL in AD.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO’Caoimh, R., Gao, Y., Svendrovski, A., Illario, M., Iaccarino, G., Yavuz, B. B., Kehoe, P. G. and Molloy, D. W. (2019) ‘Effect of visit-to-visit blood pressure variability on cognitive and functional decline in mild to moderate Alzheimer’s Disease’, Journal of Alzheimer's Disease, 68(4), pp. 1499-1510. doi: 10.3233/JAD-180774en
dc.identifier.doi10.3233/JAD-180774en
dc.identifier.eissn1875-8908
dc.identifier.endpage1510en
dc.identifier.issn1387-2877
dc.identifier.issued4en
dc.identifier.journaltitleJournal of Alzheimer's Diseaseen
dc.identifier.startpage1499en
dc.identifier.urihttps://hdl.handle.net/10468/7913
dc.identifier.volume68en
dc.language.isoenen
dc.publisherIOS Pressen
dc.relation.isbasedonDoxycycline And Rifampicin for Alzheimer’s Disease (DARAD) Randomised Controlled Trial
dc.relation.urihttp://www.isrctn.com/ISRCTN15039674
dc.rights© 2019, the Authors. The final publication is available at IOS Press through http://dx.doi.org/ 10.3233/JAD-180774en
dc.subjectVisit-visit-variabilityen
dc.subjectBlood pressure variabilityen
dc.subjectBlood pressureen
dc.subjectCognitionen
dc.subjectAlzheimer's Diseaseen
dc.titleEffect of visit-to-visit blood pressure variability on cognitive and functional decline in mild to moderate Alzheimer's Diseaseen
dc.typeArticle (peer-reviewed)en
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