The Association of Age at Diagnosis of Hypertension with Cognitive Decline: the China Health and Retirement Longitudinal Study (CHARLS)

This study investigated whether an individual's age at diagnosis of hypertension, which is associated with a decline in cognitive performance in the China Health and Retirement Longitudinal Study (CHARLS) participants. Our analysis was based on the CHARLS with baseline data collected between 2011 and 2018. We randomly selected a control participant for each hypertensive participant using propensity score. The cohort comprised 2413 individuals with hypertension and 2411 controls. Participants were divided into three groups as follows: non-hypertension, hypertension diagnose ≥55 years, and hypertension diagnose <55 years. Cognitive performance was measured in both visits and evaluated by the scores of the memory, executive function, and orientation and global cognitive. After multivariable adjustment, individuals with hypertension diagnosed <55 years had a significantly faster cognitive decline in memory test (β (95% CI, −1.117 [−1.405, −0.83]), orientation test (β (95% CI, −1.273 [−1.348, −1.198]) and global cognitive (β (95% CI, −1.611 [−1.744, −1.478]) compared with the corresponding controls. A longer hypertension duration was associated with worse memory test (β (95% CI, −0.069 [−0.113 to −0.025]). Among treated individuals, blood pressure control at baseline was inversely associated with the decline in orientation test (β (95% CI, −0.659 [−0.939, −0.380]), orientation test (β (95% CI, −0.259[−0.365, −0.153])and global cognitive (β (95% CI, −0.124 [−0.162, −0.086]). Our findings suggest that hypertension diagnosed in mid-life is associated with worse cognition compared to late life. Besides, longer duration of diagnosis is associated with worse memory test. In addition to hypertension, pressure control might be critical for the preservation of cognitive function.