The association of pulse pressure change with memory decline in middle-aged and older adults

BACKGROUND: Less is known regarding the association of pulse pressure (PP) with memory function. This study aimed to characterize long-term patterns of PP in middle-aged and older adults and explore their impact on subsequent change in memory function. METHODS: Data from the English Longitudinal Study of Ageing (ELSA, 2004-2018), were analyzed. Totally, 3587 dementia-free participants with three measurements of BP were included. All three visits of PP (2004-2012) were used to characterize longitudinal patterns of PP by group-based trajectory modeling (GBTM). Generalized estimating equation (GEE) models were fitted to explore the impact of PP trajectories on change in memory over a subsequent 6-year period (2012-2018). RESULTS: Using GBTM, three distinct trajectories of PP were identified: low-stable (38.1%), moderate-stable (48.6%), and elevated-increasing group (13.3%). GEE model suggested that memory declined over a 6-year period in all PP trajectories (all Ptime <0.001). The overall interactions between patterns of PP changes and time with memory were statistically significant (χ² interaction = 20.69, p = 0.002). Compared to participants in the low-stable group, those in the moderate-stable and elevated-increasing group exhibited a faster decline in memory. CONCLUSIONS: Longitudinal patterns of moderate-stable and elevated-increasing PP were associated with an accelerated decrease in memory. Controlling BP instability may be a promising interventional strategy for preventing cognitive decline among older adults.