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Biomedical subjects

S Inch

Publications and source records attributed to S Inch.

17 recordsLinked to original sources
PubMed2000

Seven-year follow-up of blood pressure in the Healthy Old People in Edinburgh (HOPE) cohort.

The relationship between blood pressure and health in old age is complex and influenced by socio-economic factors. The Healthy Old People in Edinburgh cohort were initially disease-free and untreated, providing a sample in which directionality in this relationship could be examined. Subjects' health status, medication use and blood pressure was ascertained at baseline, after 4 years, and again after 7 years. Socio-demographic and socio-economic data were also collected. A total of 603 subjects were seen at baseline, 429 at 4 years and 301 at 7 years; complete blood pressure data were available for 294. Mean blood pressures were 157/85 mm Hg, 159/87 mm Hg and 162/86 mm Hg at baseline, 4 years and 7 years respectively. When subjects with diagnosed hypertension were excluded, the presence of disease (P = 0.009) and medication use (P = 0.047) at 7 years were associated with a relative reduction in blood pressure over time. For these subjects disease was predicted by deprivation index of residential area (OR 1.24, 95% CI 1.10-1.40 per Carstairs unit) and occupational group (OR 0.85, 95% CI 0.74-0.97 per major group). In this cohort disease, excluding hypertension itself, significantly attenuated the age-related rise in systolic blood pressure; the longer disease has been present the less the increase. In addition, socio-economic variables are important predictors of blood pressure change in those with disease. Deprivation index of residential area was a better predictor of disease than previous occupation in these subjects who had retired over a decade previously. Journal of Human Hypertension (2000) 14, 773-778

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PubMed1997

Blood pressure and cognitive decline in healthy old people.

Both hypertension and cognitive decline are common in old age. We sought to examine the effects of blood pressure (BP) on rates of cognitive decline in a longitudinal study of community-resident healthy old people. A total of 603 initially healthy old people aged over 69 years were visited at home. Subject's age, years of full-time education, Social Occupational Classification, health status and medication use were recorded. Sitting systolic and diastolic BP was measured, and the Mini-Mental State Examination (MMSE) and National Adult Reading Test (NART) administered. Follow-up was planned after 4 years: 69 subjects were dead, 15 were too unwell and 12 had moved away; 78 subjects either refused or failed to reply. Psychometric tests were administered to the remaining 429 (71.1%) after a median period of 4.20 years. Forty-two subjects had significant sensory impairment or interrupted testing. No significant differences in cognitive decline were found between those who had started medication (n = 163) and those remaining untreated (n = 224). Mean MMSE score change was 0.44 points (s.d. 2.07, P < 0.001). Entering all baseline variables into a stepwise regression analysis significant positive effects were found for initial MMSE score (beta = 0.50, P < 0.001), age (beta = 0.17, P < 0.001), systolic BP (beta = 0.16, P < 0.001) and period between testing (beta = 0.14, P = 0.004), and negative effect for NART-predicted IQ (beta = -0.16, P = 0.003).). We conclude that (1) older people exhibit faster age-associated cognitive decline as measured by MMSE; (2) people with higher NART-predicted IQs are relatively protected; (3) people with high systolic BPs are at greater risk of cognitive decline.

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PubMed1997

Age-associated cognitive decline in healthy old people.

BACKGROUND: disease often confounds the identification of risk factors for age-associated cognitive decline in elderly subjects. If the cognitive effects of ageing are to be distinguished from those of disease, healthy people need to be studied. METHODS: we examined the effects of incident disease and drug prescription on cognitive change in a sample of initially healthy old people in a longitudinal study and related these to age, education, social class and blood pressure. We screened general practice case notes of 10,000 patients aged 70 years and over resident in Edinburgh to identify potentially healthy subjects. We visited 1467 potential subjects at home and enquired directly about health problems and medications, administered the Mini-Mental State Examination (MMSE) and National Adult Reading Test and recorded educational attainment, occupation and blood pressure. RESULTS: 603 subjects (237 male, 366 female), mean age 75.7 years (range 70-88 years), reported no health problems and were taking no regular medications. Four years after the initial visit we determined the outcome of all 603 subjects and retested available survivors. Psychometric tests were then administered to the 429 (71.1%) available survivors after a median period of 4.2 years (69 subjects were dead, 15 were too unwell, 12 had moved away and 78 either refused or failed to reply). Forty-two subjects had significant sensory impairment or interrupted testing, 195 remained in good health, 29 reported or had documented disease but were on no regular medication and 163 were on regular medication for diseases diagnosed during the follow-up period. MMSE score declined by 0.3 points in the healthy group (P < 0.048). However, once a single outlier whose MMSE score fell from 29 to 22 was excluded, the mean decline for the remainder was non-significant at 0.2 points (P = 0.079). There was no significant difference in cognitive decline between those who had and those who had not started medication (P = 0.59). CONCLUSIONS: the study fails to support the hypothesis that cognitive decline can be attributed to age alone in healthy old people. If such a decline exists, we consider that it is unlikely to account for loss of more than 0.1 MMSE point per year.

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PubMed1994

A double-blind trial of captopril or bendrofluazide in newly diagnosed senile hypertension.

Hypertension is a major risk factor for stroke and heart disease in the elderly. Eighty-one hypertensive subjects with mild cognitive impairement, aged over 70 years, were drawn from a community screening programme and randomized to either 12.5 mg captopril twice daily or 2.5 mg bendrofluazide daily in a double-blind trial. Subjects were excluded if they had previously received antihypertensive treatment. The mean blood pressure was reduced from 193/101 mmHg to 154/87 mmHg by captopril and from 188/102 mmHg to 151/89 mmHg by bendrofluazide after 24 weeks; there was no significant difference between the two drugs. Seven subjects withdrew due to adverse events. Adverse events occurred more frequently during the 2-week placebo phase than during active treatment with either drug. The only significant detrimental changes in pre-existing conditions were in 3 subjects (2 captopril, 1 bendrofluazide) who were noted to have worsening of their cataracts. One subject on captopril and 4 subjects on bendrofluazide became hypokalaemic. The trial results support the use of captopril as an alternative to bendrofluazide as a first-line antihypertensive agent in the community for elderly people, but large studies are required to measure accurately effects on significant morbidity and mortality.

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PubMed1993

Blood pressure and cognitive function in healthy old people.

OBJECTIVE: Since hypertension is a major risk factor for multi-infarct dementia, this study aimed to evaluate the effect of blood pressure on cognitive function in elderly subjects on no medication and disease-free. DESIGN: A cross-sectional survey. SETTING: Community. PARTICIPANTS: 598 healthy community-resident subjects aged 70 years and over who were on no treatment. MEASUREMENTS: Blood pressure (BP) and MMSE score, an index of cognitive function. RESULTS: Mean age of the sample was 75.7 years, mean BP 160/86 mmHg, mean MMSE 28.0. Systolic BP correlated negatively with MMSE (P < 0.05), but diastolic BP showed no significant overall correlation. To study possible J-shaped curve effects of BP, the sample was stratified into three groups--low BP, normal BP, and high BP--at levels one standard deviation from the mean for both systolic and diastolic pressures. Mean MMSE scores for low, normal and high systolic BP were 28.3, 28.1, 27.5, respectively; for low, normal, and high diastolic BP scores were 28.0, 28.1, and 27.5 respectively. Multivariate analysis of variance found the differences between normal and high to be significant at P < 0.001 for systolic and P = 0.001 for diastolic BPs. CONCLUSION: High blood pressure is associated with cognitive impairment in healthy, drug-free, older people.

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PubMed1992

Elderly drivers.

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