Temporal dynamics of blood pressure, functional status and cognitive function in adults aged 85 years and older: a dynamic time warping approach in the Leiden 85-plus study

Age and Ageing, vol. 55

Abstract

INTRODUCTION: High blood pressure (BP), functional decline, and cognitive decline commonly co-occur in late life. The temporal dynamics between changes in BP and changes in functional or cognitive status remain unclear. The aim of this study is to explore these temporal dynamics in adults aged 85 years and older using dynamic time warping (DTW). METHODS: This study used data from the Leiden 85-plus Study. BP, functional status and cognitive function were measured at baseline (age 85) and annually over 5 years. Participants with at least three measurements were included (n = 429 of 599). Functional status was assessed using the Groningen Activity Restriction Scale for Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Cognitive function was measured with the Mini-Mental State Examination (MMSE). DTW was applied to assess temporal relationships. RESULTS: The 429 participants were all aged 85 years at baseline, 69% were female and 39% used antihypertensive medication. Increases in BP over time were associated with later IADL decline, while BP decreases were associated with later IADL improvement (P < .05). Similarly, decreases in diastolic BP over time were associated with later decreases in MMSE, while increases in diastolic BP were linked to later improvements in MMSE (P < .05). CONCLUSION: BP changes were associated with subsequent inverse IADL changes over time, while changes in diastolic BP preceded concordant changes in cognitive function. These findings highlight the importance of BP changes in old age, as they might indicate later functional or cognitive decline.

Authors 8

1. Jan J. Duin corresponding Aachen Department of Internal Medicine Section of Gerontology and Geriatrics LUMC Center for Medicine for Older People

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center , Leiden ,

   LUMC Center for Medicine for Older People, Leiden University Medical Center , Leiden ,

2. Stella Trompet Aachen Department of Internal Medicine Section of Gerontology and Geriatrics LUMC Center for Medicine for Older People

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center , Leiden ,

   LUMC Center for Medicine for Older People, Leiden University Medical Center , Leiden ,

3. Erik J. Giltay Aachen Department of Psychiatry, Leiden University Medical Center Health Campus The Hague Department of Public Health and Primary Care

   Leiden University Medical Center

   Affiliation as printed

   Department of Psychiatry, Leiden University Medical Center , Leiden ,

   Health Campus The Hague, Department of Public Health and Primary Care, Leiden University Medical Center , Leiden ,

4. Jacob T Johnson Aachen Department of Internal Medicine Section of Gerontology and Geriatrics LUMC Center for Medicine for Older People

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center , Leiden ,

   LUMC Center for Medicine for Older People, Leiden University Medical Center , Leiden ,

5. Prof Jacobijn Gussekloo Aachen Department of Internal Medicine Section of Gerontology and Geriatrics Department of Public Health and Primary Care LUMC Center for Medicine for Older People

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center , Leiden ,

   Department of Public Health and Primary Care, Leiden University Medical Center , Leiden ,

   LUMC Center for Medicine for Older People, Leiden University Medical Center , Leiden ,

6. Rosalinde K. E. Poortvliet Aachen Department of Public Health and Primary Care LUMC Center for Medicine for Older People

   Leiden University Medical Center

   Affiliation as printed

   Department of Public Health and Primary Care, Leiden University Medical Center , Leiden ,

   LUMC Center for Medicine for Older People, Leiden University Medical Center , Leiden ,

7. Simon P. Mooijaart Aachen Department of Internal Medicine Section of Gerontology and Geriatrics LUMC Center for Medicine for Older People

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center , Leiden ,

   LUMC Center for Medicine for Older People, Leiden University Medical Center , Leiden ,

8. Frederiek van den Bos Aachen Department of Internal Medicine Section of Gerontology and Geriatrics LUMC Center for Medicine for Older People

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center , Leiden ,

   LUMC Center for Medicine for Older People, Leiden University Medical Center , Leiden ,