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Age of hypertension onset and cognitive function in the elderly: an observational study from the NHANES 2011–2014

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Key summary points

AbstractSection Aim

This study aims to evaluate the association between age of hypertension onset and cognitive function in a representative sample of US older adults.

AbstractSection Findings

Compared with those without hypertension, early onset hypertension was associated with – 4.15 (95% CI – 6.63, – 1.68), – 1.10 (95% CI – 2.08, – 0.12), – 0.75 (95% CI – 1.91, 0.42), and – 0.56 (95% CI – 0.94, – 0.19) scores for the digit symbol substitution test (DSST), the animal fluency test, the consortium to establish a registry for Alzheimer’s disease (CERAD), and a composite-z score calculated by summing z-scores from these three individual tests.

AbstractSection Message

Our findings highlight the importance of assessing the age of onset in evaluating the risk of cognitive decline in patients with hypertension.

Abstract

Purpose

This study aims to evaluate the association between age of hypertension onset and cognitive function in a representative sample of US older adults.

Methods

We assessed 2334 elderly adults (including 1655 hypertensive patients) who participated in the National Health and Nutrition Examination Survey 2011–2014. We used the age when the participants were first informed by the doctor that they had hypertension or were first clinically diagnosed with hypertension as the age of onset of hypertension. The Digit Symbol Substitution test (DSST), the Animal Fluency test, the Consortium to Establish a Registry for Alzheimer’s disease (CERAD), and a composite-z score calculated by summing z-scores from these three individual tests, were used to assess cognitive function.

Results

Participants with hypertension onset age < 35 years (early onset hypertension) had the worst performance in almost all cognitive tests, followed by those with onset age ≥ 65 years. Compared with those without hypertension, early onset hypertension was associated with − 4.15 (95% CI − 6.63, − 1.68), − 1.10 (95% CI − 2.08, − 0.12), − 0.75 (95% CI − 1.91, 0.42), and − 0.56 (95% CI − 0.94, − 0.19) scores for DSST, animal fluency test, CERAD, and composite z-score. Participants with early onset hypertension (onset age < 35 years) had higher odds for cognitive decline defined by DSST (OR: 3.28, 95% CI 1.94, 5.54) and composite z-score (OR: 1.77, 95% CI 1.07, 2.92).

Conclusions

Early onset hypertension was associated with the worst performance in cognitive function and an increased odds of cognitive decline in the elderly.

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Data availability

The data sets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We appreciate all the NHANES participants and staff for their invaluable efforts and contributions.

Funding

This work was supported by the Science and Technology Project of Sichuan Provincial Health Commission (No. 23LCYJ045), and the Sichuan Provincial Science and Technology Program (No. 2023YFS0116).

Author information

Author notes

  1. Min Wu and Cong Lu contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, The Sixth People’s Hospital of Chengdu, Chengdu, China

    Min Wu

  2. Institute of Cardiovascular Diseases and Department of Cardiology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China

    Cong Lu, Fuli Chen, Gang Li & Long Zhou

  3. School of Public Health, Xi’an Medical University, Xi’an, China

    Yameng Fan

Authors
  1. Min Wu
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  2. Cong Lu
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  3. Fuli Chen
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  4. Yameng Fan
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  5. Gang Li
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  6. Long Zhou
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Contributions

LZ and GL designed the present study and performed data analysis; MW and CL contributed equally to the writing of this article; FC and YF contributed to the data interpretation. All authors approved the final version of the manuscript to be published.

Corresponding authors

Correspondence to Gang Li or Long Zhou.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All methods were carried out in accordance with the Declaration of Helsinki and the study protocol was approved by the National Center for Health Statistics (NCHS) Research Ethics Review Board (Protocol #2011–17).

Informed consent

Informed consent was obtained from all participants.

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Wu, M., Lu, C., Chen, F. et al. Age of hypertension onset and cognitive function in the elderly: an observational study from the NHANES 2011–2014. Eur Geriatr Med 15, 561–570 (2024). https://doi.org/10.1007/s41999-023-00920-9

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  • DOI: https://doi.org/10.1007/s41999-023-00920-9

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