Hypertension as a risk factor for transitions from normal to dementia or mild cognitive impairment

Objective: To investigate whether hypertension at baseline is associated with transitions from cognitively normal to mild cognitive impairment (MCI) or early dementia with death as a competing state. Methods: Cognitive assessments from 440 subjects enrolled in a longitudinal study at the University of Kentucky Alzheimer's Disease Center were used to classify individuals into one of three transient states at any visit: cognitively normal, amnestic MCI, or mixed MCI. Between visits subjects could die or become demented. A series of polytomous logistic models were used to determine if transitions varied with hypertension after adjustment for age, education, gender, family history of dementia, and APOE status. Results: Hypertension protects against transitions from cognitively normal or mixed MCI to dementia (P = 0.0037 and 0.017, respectively) but not from amnestic MCI to dementia (P = 0.92). Conclusion: Hypertension is a risk factor for death but not dementia or transitions to the MCI states.