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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Rajesh S Pandav, MBBS, MPH, Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, 412-3839584, pandavr@msx.upmc.edu, Hiroko H. Dodge, PhD, Dept. of Epidemiology, University of Pittsburgh, 127 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261, and Mary Ganguli, MD, MPH, Department of Psychiatry, School of Medicine & Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213.
Cross-national epidemiological studies can shed light on potential risk factors by identifying similarities and differences in disease associations in disparate populations. We evaluated the cross-sectional relationship between blood pressure and cognitive impairment in two rural older populations in India and the USA.
Participants numbered 4810 (age 55+) in Ballabgarh, India and 636 (age 75+ ) in the Monongahela Valley (USA). In a case-control design within two cohort studies, applying standardized blood pressure measurement, the outcome measure was cognitive impairment, defined as scores <=the 10th percentile of each cohort on a general mental status test; the Mini Mental State Exam (USA) and the Hindi Mental State Examination (India).
Mean systolic (SBP) and diastolic blood pressure (DBP) in mm Hg were 115 and 75 (India), and 141 and 76 (USA). Logistic regression adjusting for age, sex, and education/literacy was used to calculate Odds Ratios and associated 95% confidence intervals for cognitive impairment. In Ballabgarh, there was a significant inverse association between cognitive impairment and both SBP (OR: 0.90, CI 0.83 – 0.97) and DBP ( OR: 0.87, CI 0.77 – 0.99) for every 10 mm of Hg increase in blood pressure. In the Monongahela Valley, a similar association between DBP and cognitive impairment did not remain significant after adjustment for confounders (OR: 0.81, CI 0.64 – 1.04).
In both Indian and American cohorts, lower DBP was inversely related to cognitive impairment although not significantly in the latter. Low blood pressure may be an effect of, or a potential risk factor for, degenerative brain disease.
Learning Objectives:
Keywords: Elderly, India
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.