Association between the blood pressure variability and cognitive decline in Parkinson's disease

Abstract Objectives High visit‐to‐visit blood pressure variability (BPV) was found to be associated with cognitive decline in the elderly. This study aimed to investigate the impact of visit‐to‐visit BPV on cognition in patients with early‐stage Parkinson's disease (PD). Design This is a retrospective analysis of a prospective cohort. Setting and participants A total of 297 patients with early‐stage PD (103 mild cognitive impairments [PD‐MCI] and 194 normal cognitions [PD‐NC] at baseline) were included from the Parkinson's Progression Markers Initiative study. Methods Variation independent of mean (VIM) of the first year was used as the indicator of BPV. The Montreal Cognitive Assessment (MoCA) was used to assess global cognition. Patients were divided into PD‐MCI and PD‐NC according to the MoCA score at baseline. Longitudinal cerebrospinal fluid (Aβ‐42, Aβ, α‐synuclein, neurofilament light protein, tau phosphorylated at the threonine 181 position, total tau, glial fibrillary acidic protein) and serum (neurofilament light protein) biomarkers were assessed. The Bayesian linear growth model was used to evaluate the relationship between baseline BPV and the rate of change in cognition and biomarkers. Results Higher systolic VIM of the first year was related to a greater rate of decline in MoCA score in the following years in PD‐MCI ( β = −.15 [95% CI −.29, −.01]). No association was found between BPV and biomarkers. Conclusion and implications Higher systolic VIM predicted a steeper decline in cognitive tests in PD‐MCI independently from the mean value of blood pressure, orthostatic hypotension, and supine hypertension.