Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Nov 19, 2023; 13(11): 872-883
Published online Nov 19, 2023. doi: 10.5498/wjp.v13.i11.872
Analysis of the relationship between blood pressure variability and subtle cognitive decline in older adults
Hui-Feng Guo, Yi Wu, Jie Li, Feng-Feng Pan
Hui-Feng Guo, Jie Li, Feng-Feng Pan, Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
Yi Wu, Prenatal Diagnosis Center, International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
Co-corresponding authors: Hui-Feng Guo and Yi Wu.
Author contributions: HF Guo and Y Wu analyzed the data and wrote the paper; Li J was responsible for execution and data collection; Pan FF was responsible for the study conception and design; the final version of the manuscript has been approved by all authors. Guo HF and Wu Y contributed equally to this work as co-corresponding authors. The reasons for designating them as co-corresponding authors are as follows: Firstly, this manuscript is a collaborative work. The designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. Secondly, Guo HF and Wu Y contributed equally to this work. The choice of these researchers as co-corresponding authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. Guo HF is responsible for the overall planning and the organization of clinical data, Wu Y is responsible for the data summary and statistical analysis. In summary, we believe that designating Guo HF and Wu Y as co-corresponding authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by Shanghai Municipal Commission of Science and Technology Program, No. 19411960900.
Institutional review board statement: The study was reviewed and approved by the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, approval No. 2022-0326.
Informed consent statement: All study participants provided written informed consent for personal and medical data collection prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The dataset is available from the corresponding author at
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hui-Feng Guo, MM, Associate Chief Physician, Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600 Yishan Road, Xuhui District, Shanghai 200233, China.
Received: August 30, 2023
Peer-review started: August 30, 2023
First decision: September 13, 2023
Revised: September 18, 2023
Accepted: October 23, 2023
Article in press: October 23, 2023
Published online: November 19, 2023

Blood pressure variability (BPV) has been shown to be related to mild cognitive impairment and Alzheimer's disease in a number of studies. However, the relationship between BPV and subtle cognitive decline (SCD) has received minimal attention in this field of research to date and has rarely been reported.


To examine whether SCD is independently associated with changes in BPV in older adults.


Participants were selected based on having participated in cognitive function evaluation and ambulatory blood pressure measurement at the Shanghai Sixth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine between June 2020 and August 2022. The participants included 182 individuals with SCD as the experimental group and 237 with normal cognitive function as the control group. The basic data, laboratory examinations, scale tests, and ambulatory blood pressure test results of the two groups were analyzed retrospectively, and the relationship between SCD and BPV was subsequently evaluated.


Significant differences were observed between the two groups of participants (P < 0.05) in terms of age, education level, prevalence rate of diabetes, fasting blood glucose level, 24-h systolic blood pressure standard deviation and coefficient of variation, 24-h diastolic blood pressure standard deviation and coefficient of variation. The scale monitoring results showed significant differences in the scores for memory, attention, and visual space between the experimental and control groups. Logistic regression analysis indicated that age, education level, blood sugar level, and BPV were factors influencing cognitive decline. Linear regression analysis showed that there was an independent correlation between blood pressure variation and SCD, even after adjusting for related factors. Each of the above differences was still significant.


This study suggests that increased BPV is associated with SCD.

Keywords: Blood pressure, Variability, Elderly, Subtle cognitive decline relationship

Core Tip: Cognitive dysfunction is a disease that seriously endangers human health, and its current treatment measures are far from perfect. Early identification, which can facilitate the implementation of early treatment, is the primary focus of this research. Our aim was to explore the correlation between blood pressure variability (BPV) and subtle cognitive decline and to understand whether BPV can be used for early detection of cognitive impairment.