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Heterogeneity in longitudinal trajectories of cognitive performance among middle-aged and older individuals with hypertension: Growth mixture modeling across an 8-year cohort study

Hypertension Research volume 45, pages 1037–1046 (2022)Cite this article

A Comment to this article was published on 01 April 2022

Abstract

Hypertension is one of the most prevalent chronic conditions and has been proven to be related to cognitive function. However, there is no evidence regarding the heterogeneity in cognitive trajectories among persons with hypertension. The aims of the current study were to characterize the heterogeneity in longitudinal trajectories of cognitive performance among Chinese middle-aged and older individuals with hypertension and to explore the potential determinants of trajectory memberships. Data from the 2011 to 2018 Chinese Health and Retirement Longitudinal Study (CHARLS) were utilized. Two cognitive measures of executive function and episodic memory were assessed, and conditional growth mixture modeling (GMM) was performed to identify the trajectories of cognitive performance and explore the related factors of cognitive change. The findings revealed three trajectory classes of executive function (stable, sharp decline, smooth decline) and two trajectory classes of episodic memory (stable, decline). Individuals with hypertension who had a higher educational level, moderate nighttime sleep duration, and lower depressive symptoms as well as those who reported consuming alcohol at least once a month were more likely to belong to the optimal stable executive function group. Subjects with a higher educational level, adequate daytime napping duration, and higher BMI were more likely to exhibit stable episodic memory over time. Other factors, including age, sex, community type, marital status, and hypertension treatment, exhibited class-specific effects on growth parameters of cognitive trajectory. Targeting intervention designation is proposed to ameliorate the burdens of cognitive impairment among individuals with hypertension.

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Acknowledgements

We thank all the participants involved in the survey design and data collection and the CHARLS research team for collecting high-quality, nationally representative data and making the data public.

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  1. West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China

    Baiyang Zhang & Shaohua Jiang

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  1. Baiyang Zhang
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Conceptualization: BZ and SJ; Methodology, BZ; software, BZ, Formal analysis, BZ and SJ; writing—original draft preparation, BZ; writing—review and editing, BZ and SJ.

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Correspondence to Baiyang Zhang.

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Zhang, B., Jiang, S. Heterogeneity in longitudinal trajectories of cognitive performance among middle-aged and older individuals with hypertension: Growth mixture modeling across an 8-year cohort study. Hypertens Res 45, 1037–1046 (2022). https://doi.org/10.1038/s41440-021-00829-5

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