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Access Type

WSU Access

Date of Award

January 2021

Degree Type


Degree Name




First Advisor

John L. Woodard


Background. Hypertension impacts approximately 65% of persons over 60 years of age. Although previous studies have examined the association of mid-life hypertension and late-life cognition, findings on the association between late-life hypertension and cognition have been mixed, in direction, magnitude, and cognitive domains. Methods. This study contrasted older adults with and without self-reported hypertension at two time points in late-life (MBaseline age=64.3 years, SD1=0.7; MFollow-up age=71.2 years, SD2=0.9), separated by approximately seven years. Participants included 5,166 1957 high school graduates from the Wisconsin Longitudinal Study, who were followed longitudinally until 2011. Cognitive, demographic, and health variables from the 2003-2005 and 2011 data collection waves were used. Cognitive measures included Letter and Category Fluency, Digit Ordering, Similarities, and Immediate and Delayed Recall. Bayesian ANCOVAs examined the association between self-reported hypertension and cognition at baseline and follow-up while controlling for hypertension duration. Results. After controlling for hypertension duration, self-reported hypertension over seven years was not associated with cognition, in comparison to people without hypertension and people that developed incident hypertension. Unlike hypertension, diabetes was associated with worse executive functioning and memory at baseline, follow-up, and residualized change. In the absence of diabetes, people with hypertension performed worse on Letter Fluency at follow-up and residualized change. Diabetes was also uniquely associated with worse Digit Ordering and Similarities performance at follow-up and residualized change. The effect sizes for diabetes were nearly twice as large as those for hypertension. Conclusions. These findings suggest a minimal association between self-reported hypertension and cognition in older adults. Instead, other comorbid cardiovascular risk factors, such as diabetes, are more strongly associated with cognition than hypertension alone.

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