Research Paper Volume 13, Issue 13 pp 17380—17406

Trajectory patterns of blood pressure change up to six years and the risk of dementia: a nationwide cohort study

Gang Cheng1, , Simin He1, , Qiong He1, , Xiaowei Xie1, , Cai Tang1, , Qunhui Xie1, , Xihong Wu1, , Ni Jiang1, , Chao Li1, , Xianying Min1, , Yan Yan1, ,

  • 1 Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China

Received: February 24, 2021       Accepted: June 8, 2021       Published: July 1, 2021
How to Cite

Copyright: © 2021 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


The present study aimed to investigate the associations between the trajectory of blood pressure (BP) change and the risk of subsequent dementia and to explore the differences in age, gender, and hypertension subgroups. We included 10,660 participants aged ≥ 60 years from 1998 to 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Latent growth mixture models were used to estimate BP trajectories. Cox-proportional hazard models were used to analyze the effects of BP trajectories on the risk of dementia. According to the results, stabilized systolic BP (SBP) was found to be associated with a higher risk of dementia compared with normal SBP [adjusted hazard ratio (aHR): 1.62; 95% confidence interval (CI): 1.27-2.07] and elevated SBP (aHR: 2.22; 95% CI: 1.51-3.28) in and only in the subgroups of the oldest-old, women, and subjects without hypertension at baseline. Similarly, stabilized pulse pressure (PP) was associated with a higher risk of dementia compared with normal PP (aHR: 1.52; 95% CI: 1.24-1.88) and elevated PP (aHR: 2.12; 95% CI: 1.48-3.04) in and only in the subgroups of the oldest-old, women, and subjects with hypertension at baseline. These findings suggest that stabilized SBP and PP have predictive significance for the occurrence of dementia in late life, and the factors of age, gender, and late-life hypertension should be considered when estimating the risk of BP decline on dementia.


BP: blood pressure; SBP: systolic BP; DBP: diastolic BP; PP: pulse pressure; aHR: adjusted hazard ratio; CI: confidence interval; CLHLS: The Chinese Longitudinal Healthy Longevity Survey; LGMM: the latent growth mixture model; AIC: Akaike Information Criterion; BIC: Bayesian Information Criterion; SSA-BIC: sample-size adjusted BIC; LMR-test: Lo-Mendell-Rubin adjusted likelihood ratio test; BLRT: bootstrap likelihood ratio test.