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15-year longitudinal study of blood pressure and dementia
Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L, Persson G, Odén A et al.. Lancet (London, England), 1996-04-01
Topic: Risk, prevention and care in population studies
Background Vascular causes of dementia may be more common than supposed. Vascular factors may also have a role in late-onset Alzheimer's disease, but the role of hypertension in the development of dementia is unclear. Methods As part of the Longitudinal Population Study of 70-year-olds in Göteborg, Sweden, we analysed the relation between blood pressure and the development of dementia in the age intervals 70-75, 75-79, and 79-85 years in those non-demented at age 70 (n = 382). The sample was followed up for 15 years and examined repeatedly with a comprehensive investigation, including a psychiatric and physical examination. a Findings Participants who developed dementia at age 79-85 had higher systolic blood pressure at age 70 (mean 178 vs 164 mm Hg, p = 0.034) and higher diastolic blood pressure at ages 70 (101 vs 92, p = 0.004) and 75 (97 vs 90, p = 0.022) than those who did not develop dementia. For subtypes of dementia, higher diastolic blood pressure was recorded at age 70 (101, p = 0.019) for those developing Alzheimer's disease and at age 75 (101, p = 0.015) for those developing vascular dementia than for those who did not develop dementia. Participants with white-matter lesions on computed tomography at age 85 had higher blood pressure at age 70 than those without such lesions. Blood pressure declined in the years before dementia onset and was then similar to or lower than that in non-demented individuals. Interpretation Previously increased blood pressure may increase the risk for dementia by inducing small-vessel disease and white-matter lesions. To what extent the decline in blood pressure before dementia onset is a consequence or a cause of the brain disease remains to be elucidated.
Key findings
- For subtypes of dementia, higher diastolic blood pressure was recorded at age 70 (101, p = 0.019) for those developing Alzheimer's disease and at age 75 (101, p = 0.015) for those developing vascular dementia than for those who did not develop dementia.
- Participants with white-matter lesions on computed tomography at age 85 had higher blood pressure at age 70 than those without such lesions.
- Blood pressure declined in the years before dementia onset and was then similar to or lower than that in non-demented individuals.
- Interpretation Previously increased blood pressure may increase the risk for dementia by inducing small-vessel disease and white-matter lesions.
- To what extent the decline in blood pressure before dementia onset is a consequence or a cause of the brain disease remains to be elucidated.
Why it matters
Swedish researchers followed 382 people without dementia from age 70 to 85. Those who developed dementia at 79–85 had higher blood pressure at age 70 (average systolic 178 vs 164 mm Hg), and higher diastolic pressure at 70 was also seen in those who went on to develop Alzheimer's disease. Their blood pressure then fell in the years before dementia began, and the authors say it is still unknown whether that fall is a cause or a consequence of the brain disease. This is an observational association: the study tested no treatment and does not show that high or low blood pressure causes dementia.
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Study details
- Study designlongitudinal study
- Participants382
- Evidence strengthModerate
How this study scored 70/100
Published in a top-tier journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Lancet (London, England)) |
| Journal's citation record | 4 / 4 | The Lancet: journal h-index 1,205 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1996 — older than 20 years, still counted |
| Sample size | 2 / 4 | 382 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,726 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 53.9 citations a year over 32 year(s) since 1996 |
| Impact for its field and year | 5 / 6 | Cited 39.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 93 other studies in this library |
| Still being cited | 3 / 4 | Cited 72 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Alvar Svanborg: h-index 43 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Gothenburg: institution h-index 972 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 8609748) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 70 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Skoog, I., Lernfelt, B., Landahl, S., Palmertz, B., Andreasson, L. A., Nilsson, L., et al. (1996). 15-year longitudinal study of blood pressure and dementia. Lancet (London, England). https://doi.org/10.1016/s0140-6736(96)90608-x
Vancouver
Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L, et al. 15-year longitudinal study of blood pressure and dementia. Lancet (London, England). 1996. doi:10.1016/s0140-6736(96)90608-x. PMID: 8609748.
BibTeX
@article{skoog1996-8609748,
author = {Skoog, I. and Lernfelt, B. and Landahl, S. and Palmertz, B. and Andreasson, L. A. and Nilsson, L. and Persson, G. and Odén, A. and others},
title = {{15-year longitudinal study of blood pressure and dementia}},
journal = {Lancet (London, England)},
year = {1996},
doi = {10.1016/s0140-6736(96)90608-x},
pmid = {8609748},
url = {https://doi.org/10.1016/s0140-6736(96)90608-x}
}
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