Long-term predictors of cognitive outcome in a cohort of older people withhypertension

Background Deteriorating cognitive function in late life substantially incr eases the risk for dementia, for other non-cognitive morbidity, for depende ncy, and early death. Aims To identify early predictors of late-life cognitive outcome. Method Cognitive function, premorbid IQ, and cardiovascular risk exposure w ere recorded on 1083 subjects on entry to a hypertension treatment trial in 1983-1984. We followed up this cohort 9-12 years later to assess cognitive function with the Mini-Mental State Examination (MMSE), to update exposure status. and to obtain genomic material. Multivariate analysis was used to identify independent baseline predictors of cognitive outcome 9-12 years la ter. Results We followed up 387 subjects (58.6% of survivors). After adjusting f or baseline cognition, poorer cognitive outcome was found to be independent ly associated with a family history of dementia, increasing age, less decli ne in systolic blood-pressure, lower premorbid IQ (rather than limited educ ation), and abstinence from alcohol. Conclusions Reduction in systolic blood pressure (among hypertensives) and moderate alcohol intake could protect against cognitive deterioration in la te life.