Midlife hypertension and late-life cognition: weighting the LifeAfter90 study.

INTRODUCTION

Midlife hypertension is a well-established predictor of late-life cognitive decline; however, few population-representative estimates of this association exist among oldest-old cohorts.

METHODS

LifeAfter90 (LA90) is an ethnoracially diverse cohort of individuals aged 90+ linked to midlife multiphasic health check-ups (MHC). We assessed executive function, semantic memory, and verbal memory at age 90+. We used stabilized inverse probability of censoring weights and linear regression to estimate the association between midlife hypertension and cognitive function in the MHC target population.

RESULTS

After weighting, LA90 participants (n = 307) were similar to the MHC population on race/ethnicity, hypertension, and education. Midlife hypertension was not associated with executive function (β = 0.03, [95% confidence interval [CI]: -0.24, 0.31]) and verbal memory (β = -0.10 [95% CI: -0.37, 0.16]). Midlife hypertension was associated with poorer semantic memory (β = -0.19 [95% CI: -0.44, 0.06]).

DISCUSSION: People with midlife hypertension averaged lower semantic memory using population-representative models, suggesting that it may have sustained impact on learning and memory in those aged 90+.