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Institute of Psychiatry, London
Academic Department of Psychiatry, Royal Free Hospital, London
Correspondence: Dr Jorge A. Cervilla, Director Médico, Complejo Hospitalario San Luis, Carretera de Burgos s/n, 34004 Palencia, Spain ; e-mail : dmedica{at}sanluis.org
Declaration of interest Supported by a grant from the Medical Research Council.
Background Deteriorating cognitive function in late life substantially increases the risk for dementia, for other non-cognitive morbidity, for dependency, and early death.
Aims To identify early predictors of late-life cognitive outcome.
Method Cognitive function, premorbid IQ, and cardiovascular risk exposure were recorded on 1083 subjects on entry to a hypertension treatment trial in 1983-1984. We followed up this cohort 9-12 years later to assess cognitive function with the Mini-Mental State Examination (MMSE), to update exposure status, and to obtain genomic material. Multivariate analysis was used to identify independent baseline predictors of cognitive outcome 9-12 years later.
Results We followed up 387 subjects (58.6% of survivors). After adjusting for baseline cognition, poorer cognitive outcome was found to be independently associated with a family history of dementia, increasing age, less decline in systolic blood-pressure, lower premorbid IQ (rather than limited education), and abstinence from alcohol.
Conclusions Reduction in systolic blood pressure (among hypertensives) and moderate alcohol intake could protect against cognitive deterioration in late life.
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