High Blood Pressure in Young Adulthood Associated With Cognitive Decline and Gait Impairment in Middle Age

The research was led by Prof. Farzaneh A. Sorond and Dr. Simin Mahinrad of Northwestern University’s Department of Neurology and Prof. Jeffrey Hausdorff of TAU’s Sackler Faculty of Medicine, TAU’s Sagol School of Neuroscience and Tel Aviv Medical Center’s Center for the Study of Movement, Cognition, and Mobility at the Neurological Institute. The study was published in the American Heart Association’s journal Circulation in March.

“We find that the deleterious effects of elevated blood pressure on brain structure and function begin in early adulthood. This demonstrates the need for preventive measures of high blood pressure even at this early age,” explains Prof. Hausdorff. “We know that poor gait and cognitive function among older adults are associated with and predict multiple adverse health outcomes like cognitive decline, dementia, falls and death. Our study shows that the time to treat high blood pressure and to minimize future changes in gait and cognition is much earlier — decades earlier — than previously thought.”

In addition, the study suggests that gait impairment may be an earlier hallmark of hypertensive brain injury than cognitive deficits.

For the study, the researchers assessed the blood pressure, gait and cognition of 191 participants from the Coronary Artery Risk Development in Young Adults study, a community-based cohort of young individuals followed over 30 years. In the last year of follow-up, gait was assessed using an instrumented gait mat; cognitive function was evaluated using neuropsychological tests; and the level of white matter intensity in the brain, a symptom of cardiovascular disease, was measured using MRIs. The impact of cumulative levels of high blood pressure was found to be independent of other vascular risk factors over the same 30-year period.

“Higher cumulative blood pressure was associated with slower walking speed, smaller step length and higher gait variability,” Prof. Hausdorff says. “Higher cumulative blood pressure was also associated with lower cognitive performance in the executive, memory and global domains.”

“Our takeaway is this: Even in young adults, blood pressure has significant implications, even at levels below the ‘hypertension’ threshold, and is important to assess and modify for future cognitive function and mobility,” Prof. Hausdorff concludes.

See the publication at the Circulation web site here.

Contacts and sources:
American Friends of Tel Aviv University

Publication: Cumulative Blood Pressure Exposure During Young Adulthood and Mobility and Cognitive Function in Midlife.  Simin Mahinrad, MD, PhD Shawn Kurian, BSc Chaney R. Garner, BA Sanaz Sedaghat, PhD Alexander J. Nemeth, MD Nicola Moscufo, PhD James P. Higgins, BSc David R. Jacobs Jr, PhD Jeffrey M. Hausdorff, PhD Donald M. Lloyd-Jones, MD, ScM Farzaneh A. Sorond, MD, PhD. Circulation.   https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.119.042502#here