OBJECTIVETo investigate the association between blood pressure and related cognitive function with Mini-Mental State Examination (MMSE) in the elderly community residents in Beijing.

METHODSA selected sample of 60 years old and over from the communities was randomized ascertained to a longitudinal study in Beijing. The baseline data was produced in 1993, in which blood pressure, MMSE and a multidisciplinary questionnaire were involved. 4 years later in 1997, a similar procedure was repeated in 2079 elderly people whose MMSE scores were normal during the baseline study.

RESULTSThe mean systolic blood pressure, diastolic blood pressure and MMSE score were 141.77 +/- 24.94 mm Hg, 81.76 +/- 12.08 mm Hg and 25.65 +/- 3.59 in baseline. The MMSE score was 23.24 +/- 5.63 in the follow-up study. Significant decline in cognition was defined as a decrease of 4 score and over during the 4-years study. The proportion of significant decline in cognition in the follow-up was larger when the systolic blood pressure or diastolic blood pressure having an increase in baseline data. Further stratified observation showed that factors as elderly with elevated blood pressure, under 75 years old from rural areas without diabetes mellitus or antihypertensive medication were more commonly seen in the ones with significant cognition decline. Increased incidence of cognitive decline was found in those with increased level of hypertension. This association was also seen in systolic blood pressure after adjustment of heart disease and cerebrovascular disease.

CONCLUSIONSIn the 4-year longitudinal study, cognitive dysfunction might cause elevated baseline systolic and diastolic blood pressure in the elderly people whose baseline MMSE scores were normal.