Abstract
Objective
To investigate the association between antihypertensive medication regimen intensity
and risk of incident dementia in an older population.
Design
Prospective, longitudinal cohort study.
Participants/Setting
A total of 1208 participants aged ≥78 years, free of dementia, and residing in central
Stockholm at baseline (2001–2004).
Measurements
Participants were examined at 3- and 6-year follow-up to detect incident dementia.
Data were collected through face-to-face interviews, clinical examinations, and laboratory
tests. Data on antihypertensive use were obtained by a physician through patient self-report,
visual inspection, or medical records. Cox proportional hazards models were used to
compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association
between time-varying antihypertensive regimen intensity and incident dementia after
adjusting for potential confounders.
Results
During the follow-up period, 125 participants were diagnosed with dementia. Participants
who developed dementia were more likely to have vascular disease at baseline (66.4%
vs 55.3%, P = .02). In fully adjusted analyses, the number of antihypertensive classes (HR 0.68,
95% CI 0.55–0.84) and total prescribed daily dose (HR 0.70, 95% CI 0.57–0.86) were
significantly associated with reduced dementia risk. After considering all-cause mortality
as a competing risk, the number (HR 0.75, 95% CI 0.62–0.91) and doses (HR 0.71, 95%
CI 0.59–0.86) of antihypertensive classes, and the independent use of diuretics (HR
0.66, 95% CI 0.44–0.99), were significantly associated with lower dementia risk.
Conclusions
Greater intensity of antihypertensive drug use among older people may be associated
with reduced incidence of dementia.
Keywords
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Article info
Publication history
Published online: January 03, 2018
Footnotes
The Swedish National Study on Aging and Care (SNAC – www.snac.org) is financially supported by the Ministry of Health and Social Affairs, Sweden; the participating county councils and municipalities and the Swedish Research Council. ET is supported by a NHMRC-ARC Dementia Research Development Fellowship and an Australian Endeavour Research Fellowship. KJ is supported by a grant from the Swedish Research Council. CQ is supported by grants from the Swedish Research Council and the Swedish Research Council for Health, Working Life and Welfare.
The authors declare no conflicts of interest.
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© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
