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Blood Pressure and Dementia?

Although Alzheimer’s disease is the most common type of dementia, there are over 100 different causes of reduced brain function and cognition…dementia.  Although we are all hopeful for a cure…or should I say cures.  So, it is huge when we begin to learn what factors predispose someone to reduced cognition and how we can modify behavior or the environment to reduce the risk and that cognitive outcome.

Let’s take them one at a time:


1.Dementia has been statistically tied to high mid-life blood pressure

Longitudinal research recently reported in the British journal Lancet Neurology statistically linked higher and rising blood pressure in early to middle age with a higher incidence of dementia in later life.  In this research “middle age” was defined as 36 to 53 years of age, and “later life” was defined as 69 and older.1.Dementia is linked to decreased brain size

This is where it is all linked.  The higher blood pressure or rising blood pressure in early life is also linked to a smaller brain volume. In the British study they followed people from birth to older age with 20 measurement points along the way.  The link between brain size adjusted for early life cognition is not necessarily a direct one.  We talk about “adjusted for early life cognition,” because people who have cognitive issues early in life tend to have more as they get older.  But those with smaller cranial size have an even great incidence of cognitive impairment.  The researchers speculate that it is the clear link between reduced brain mass and the development of white matter brain lesions that gives rise to the dementia, not just a matter of brain size.

2.White matter brain lesions are linked to the later onset of dementia

Here is where the link becomes really concrete.  The researchers showed that a given increase in blood pressure yielded quantifiably more white matter lesions.  Back to brain size, the same sort of trade off was demonstrated with brain size…more pressure yields smaller brain mass.  The bigger the increases in blood pressure the greater the incidence of white matter and the smaller the brains.

3. 30% of dementia cases are modifiable

Yet, blood pressure alone was not directly associated with cognitive function at any given point in time.  It was the early rise and sustained high blood pressure that created the brain size and white matter problems later.  These were tied to diminished cognitive abilities.  And this now gets back to modifying risk factors for dementia, and it is pretty clear.  Everyone gets their blood pressure check early and regularly…and gets it under control if it is elevated!

4. All of the above

Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.


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