Scientists have suggested through a new study that it is possible to reduce the risk of cognitive impairment in older people if their blood pressure is controlled appropriately. Scientists say that mild cognitive impairment (MCI) is a precursor of early dementia and if great attention is given to controlling blood pressure in older people, there is a strong indication that risk of dementia can be reduced. The findings are the result of a clinical trial led by scientists at Wake Forest School of Medicine, part of Wake Forest Baptist Health.
MCI is a condition in which there is decline in memory and thinking skills at levels that are higher than expected with normal aging and is a risk factor for dementia. Dementia is defined as a group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities.
The clinical trial, which enrolled 9361 volunteers, was conducted at 102 sites in the United States and Puerto Rico among adults 50 and older with hypertension but without diabetes or history of stroke. The participating group was 35.6 percent female, 30 percent black and 10.5 percent Hispanic and thus representative of the broader U.S. population.
Participants were randomly assigned to a systolic blood pressure goal of either less than 120 mm HG (intensive treatment) or less than 140 mm HG (standard treatment). They were then classified after five years as having no cognitive impairment, MCI or probable dementia.
SPRINT was stopped early due to the success of the trial in reducing cardiovascular disease. As a result, participants were on intensive blood pressure lowering treatment for a shorter period than originally planned. The authors concluded that the shorter time may have made it difficult to accurately determine the role of intensive blood pressure control on dementia cases.
Jeff Williamson, M.D., professor of gerontology and geriatric medicine at Wake Forest School of Medicine said some caution should be exercised in interpreting the study result both because MCI was not the primary cognitive focus of the trial and because it is not clear what intensive blood pressure control may mean for the longer-term incidence of dementia. Although MCI considerably increases the risk of dementia, this progression is not inevitable and reversion to normal cognition is possible, he said.