Hypertension, Cognitive Decline, and Mild Cognitive Impairment Among Diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging Results (SOL-INCA)

Article type: Research Article

Authors: Márquez, Freddie^a | Tarraf, Wassim^b | Stickel, Ariana M.^{a; c} | González, Kevin A.^a | Testai, Fernando D.^d | Cai, Jianwen^e | Gallo, Linda C.^c | Talavera, Gregory A.^c | Daviglus, Martha L.^f | Wassertheil-Smoller, Sylvia^g | DeCarli, Charles^h | Schneiderman, Neilⁱ | González, Hector M.^{a; *}

Affiliations: [a] Department of Neurosciences and the Shiley-Marcos Alzheimer’s Disease Research Center, UC San Diego, San Diego, CA, USA | [b] Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA | [c] Department of Psychology, San Diego State University, San Diego, CA, USA | [d] Department of Neurology and Rehabilitation, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA | [e] Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA | [f] Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA | [g] Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA | [h] Department of Neurology and Alzheimer’s Disease Center, UC Davis, Sacramento, CA, USA | [i] Department of Psychology, University of Miami, Miami, FL, USA

Correspondence: [*] Correspondence to: Hector M. González, PhD, UC San Diego, Department of Neurosciences and the Shiley-Marcos Alzheimer’s Disease Research Center, 9500 Gilman Drive #0949, La Jolla, CA 92093-0949, USA. Tel.: +1 858 534 5361; E-mail: [email protected].

Abstract: Background:Hypertension can have deleterious effects on cognitive function; however, few studies have examined its effects on cognition among Hispanics/Latinos. Objective:To assess associations between hypertension status with 1) change in cognitive performance, and 2) having mild cognitive impairment (MCI) among diverse Hispanics/Latinos. Methods:This population-based, prospective cohort, multisite study included Hispanic/Latino adults aged 45 to 72 years in enrolled in the Hispanic Community Health Study/Study of Latinos at Visit 1 (2008–2011; mean age of 63.40±8.24 years), and the Study of Latinos-Investigation of Neurocognitive Aging at Visit 2 (2016–2018), with a mean follow-up duration of 7 years (n = 6,173). Hypertension status was assessed at both visits: normotension (no hypertension), incident hypertension (only at Visit 2), and persistent hypertension (at both visits). We examined change in cognitive performance and having MCI (only assessed at Visit 2) relative to hypertension status and adjusted for demographics and cardiovascular disease risk factors. Results:Compared to normotension, persistent hypertension was associated with significantly increased decline in verbal fluency (β= –0.08; CI = [–0.16;–0.01]; p < 0.05), and processing speed (β= –0.11; CI = [–0.20;–0.02]; p < 0.05). Incident hypertension was not associated with significant change in cognitive performance. Both incident (OR = 1.70; CI = [1.16;2.50]; p < 0.01) and persistent hypertension (OR = 2.13; CI = [1.57;2.88]; p < 0.001) were associated with significantly higher odds ratios of having MCI. Conclusions:These findings indicate that persistent hypertension is associated with clinical impairment and domain-specific cognitive decline in middle-aged and older Hispanics/Latinos. It underscores the importance of monitoring blood pressure in routine healthcare visits beginning at midlife in this population to reduce the burden of cognitive decline.

Keywords: Alzheimer’s disease, blood pressure, cognitive decline, cognitive function, dementia, epidemiology, Hispanics, hypertension, Latinos, mild cognitive impairment, neuroepidemiology, neuropsychology, population neuroscience

DOI: 10.3233/JAD-230424

Journal: Journal of Alzheimer's Disease, vol. 97, no. 3, pp. 1449-1461, 2024