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Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals
Levine DA, Gross AL, Briceño EM, Tilton N, Kabeto MU, Hingtgen SM, Giordani BJ, Sussman JB et al.. JAMA neurology, 2020-07-01
Topic: Risk, prevention and care in population studies
Importance Black individuals are more likely than white individuals to develop dementia. Whether higher blood pressure (BP) levels in black individuals explain differences between black and white individuals in dementia risk is uncertain. Objective To determine whether cumulative BP levels explain racial differences in cognitive decline. Design, setting, and participants Individual participant data from 5 cohorts (January 1971 to December 2017) were pooled from the Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represented a 0.1-SD difference in cognition. The median (interquartile range) follow-up was 12.4 (5.9-21.0) years. Analysis began September 2018. Main outcomes and measures The primary outcome was change in global cognition, and secondary outcomes were change in memory and executive function. Exposures Race (black vs white). Results Among 34 349 participants, 19 378 individuals who were free of stroke and dementia and had longitudinal BP, cognitive, and covariate data were included in the analysis. The mean (SD) age at first cognitive assessment was 59.8 (10.4) years and ranged from 5 to 95 years. Of 19 378 individuals, 10 724 (55.3%) were female and 15 526 (80.1%) were white. Compared with white individuals, black individuals had significantly faster declines in global cognition (-0.03 points per year faster [95% CI, -0.05 to -0.01]; P = .004) and memory (-0.08 points per year faster [95% CI, -0.11 to -0.06]; P Conclusions and relevance These results suggest that black individuals' higher cumulative BP levels may contribute to racial differences in later-life cognitive decline.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Levine, D. A., Gross, A. L., Briceño, E. M., Tilton, N., Kabeto, M. U., Hingtgen, S. M., et al. (2020). Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals. JAMA neurology. https://doi.org/10.1001/jamaneurol.2020.0568
Vancouver
Levine DA, Gross AL, Briceño EM, Tilton N, Kabeto MU, Hingtgen SM, et al. Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals. JAMA neurology. 2020. doi:10.1001/jamaneurol.2020.0568. PMID: 32282019.
BibTeX
@article{levine2020-32282019,
author = {Levine, D. A. and Gross, A. L. and Briceño, E. M. and Tilton, N. and Kabeto, M. U. and Hingtgen, S. M. and Giordani, B. J. and Sussman, J. B. and others},
title = {{Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals}},
journal = {JAMA neurology},
year = {2020},
doi = {10.1001/jamaneurol.2020.0568},
pmid = {32282019},
url = {https://doi.org/10.1001/jamaneurol.2020.0568}
}
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Key findings
- Results Among 34 349 participants, 19 378 individuals who were free of stroke and dementia and had longitudinal BP, cognitive, and covariate data were included in the analysis.
- Compared with white individuals, black individuals had significantly faster declines in global cognition (-0.03 points per year faster [95% CI, -0.05 to -0.01]; P = .004) and memory (-0.08 points per year faster [95% CI, -0.11 to -0.06]; P < .001) but significantly slower declines in executive function (0.09 points per year slower [95% CI, 0.08-0.10]; P < .001).
Why it matters
Black individuals had faster declines in global cognition and memory than white individuals, and the study examined whether cumulative blood pressure levels explained this difference. It addresses racial differences in cognitive decline and does not test a treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Study designlongitudinal study
- Participants349
- Effect size55.3%; 80.1%
- Evidence strengthModerate
How this study scored 67/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA neurology) |
| Journal's citation record | 2 / 4 | JAMA Neurology: journal h-index 235 (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 | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 349 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 5 / 7 | Cited 106 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 13.2 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 3 / 6 | Cited 7.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 11 other studies in this library |
| Still being cited | 3 / 4 | Cited 57 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Andrzej T. Gałecki: h-index 57 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 13 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32282019) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 67 / 100 | — |
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Read the original
- DOI: 10.1001/jamaneurol.2020.0568
- PubMed: 32282019
- Original source →
- Free full text: JAMA Neurology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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