--Original published at Ben's PSY105 Blog
New Study Finds Possible Link Between Blood Pressure Treatment and Preventing Dementia
In today’s
world, almost everyone has had their life impacted by dementia. Dementia is the
severe mental decline lots of people experience as they get older. Whether it
be a parent, grandparent, friend, or neighbor dementia has touched almost
everyone in one way or another. Watching someone you know slowly fade away and
become a shell of themselves is devastating. About 9.9 million people develop
dementia every year. As of now, there is no cure for dementia. For the most
common form of dementia, Alzheimer’s disease, there is no treatment to even
slow the development. This new study has given a glimmer of hope of finding a
possible preventative treatment for dementia.
The Systolic
Blood Pressure Intervention Trial (SPRINT) study aimed to see how lowering a
patient’s systolic blood pressure (the top number) to a more intensive target
of 120 mm Hg rather than the standard 140 mm Hg affected the patient’s
cardiovascular health as well as mental health. The study involved over 9,300
patients over 50 with hypertension, which is defined as systolic blood pressure
over 130 mm Hg, and no history of stroke or diabetes. According to the American
Heart Association, over 100 million Americans have high blood pressure. The
patients were randomly assigned to the treatment groups. The study took place
over five years from 2010 to 2015. The study found the more intensive treatment
lowered the risk of cardiovascular events by 25% and the risk of death by 27%.
The
cognitive portion of the study, SPRINT Memory and Cognition IN Decreased
Hypertension (SPRINT MIND), looked at how the intensive treatment affected
patients’ cognitive functioning after the treatment ended. Over 8,500 of the
patients participated in at least one cognitive follow-up assessment. The study
aimed primarily to see if the intensive treatment had any impact on the
development of “probable dementia” in the patients. Of the 4,278 patients
treated with the intense treatment, 149 had developed probable dementia. In the
group treated with the standard treatment, 176 out of 4,285 had developed
probable dementia. While there were fewer in the intensive group, it was not a
statistically significant amount.
The secondary outcome of the SPRINT MIND study looked at the development of Mild Cognitive Impairment (MCI) in patients. While MCI is not considered to impact the daily life of someone who has it, it often leads to dementia later in life. Up to 60% of patients diagnosed MCI went on to develop dementia within ten years, and everyone who has dementia had MCI first. The researchers used a series of progressive tests to determine whether the patient had MCI. The results of the study showed 287 patients in the intensive treatment group had developed MCI while 353 patients in the standard treatment group developed MCI. Based on these results, the researchers concluded the patients treated with the intensive treatment were 19% less likely to develop MCI. While this was only applicable to the patients over 50 with hypertension and no history of stroke or diabetes, it is still promising since preventing MCI is effectively preventing dementia.
The study showed the results the researchers were after in the cardiovascular portion of the study but not the cognitive portion. Despite not having significant results in the cognitive portion, they were still able to find hope of reducing dementia. Dr. Jeff Williamson, the lead researcher, has begun offering intensive treatment to his patients because of the cardiovascular benefits and the 19% decrease in the likelihood of MCI. Dr. Kristine Yaffe, a neurology professor at the University of California, on the other hand, is not ready to replace the standard treatment with then intensive method yet. She acknowledged the hope it gives to one day find an effective treatment or prevention method for dementia, but she wants to see more research done on the cognitive impact of intensive blood pressure treatment. Thanks to funding from the Alzheimer’s Association, the SPRINT MIND study will continue for two more years. The researchers hope the results will be more significant by the end since dementia takes a long time to develop.
Reflection
In writing
this article, the most difficult part was simplifying the terminology into a
vocabulary which could be more easily understood by the general public. The
medical jargon used in the academic paper made sense but only with background
knowledge of the terms being used. For example, most people wouldn’t be able to
tell you what their systolic blood pressure is, but if you ask them for the top
number of their blood pressure, they would be more likely to be able to give an
answer. Lots of people have a general knowledge of their personal health, but
not many people have the experience to understand what their numbers mean.
Along with simplifying the language, I also had to decide which information was
the most necessary to include. To do so I looked for information that pertained
directly to how the results of the study matter. The scientific paper featured
a lot of the logistics of the study. I had to put enough information to satisfy
the critical questions in reading research but not too much to overwhelm the
reader with nothing but numbers. Even trying to make the research more
accessible, I still had to try to make sure to answer the five critical
questions for reading research studies.
Along with
simplifying the academic paper into a more accessible language, I also cut out
some filler from the NYTimes article. A sizable portion of the article was
commentary from Dr. Jeff Williamson, the lead researcher of the SPRINT study,
and Dr. Kristine Yaffe, a neurology professor at the University of California.
The pair shared an opinion on the findings offering hope for finding a
treatment or preventative method for dementia. The pair disagreed, however, on
how the results should impact current treatment methods. Dr. Yaffe believes
there is still a lot of research to be done before making the intensive
treatment the standard method of blood pressure reduction. Dr. Williamson has
begun offering his patients the intensive method, telling them it lowers the
chance of mild cognitive impairment by 19%. It was important to have the expert
opinions, but the NYTimes article focused on the commentary almost as much as
the results of the study.
This
assignment made me respect journalists more. Until this, I never considered the
amount of work which goes into writing an article reporting on a scientific
journal. I always felt like they were easy, based on the typical brevity. I
took the condensing of the information for granted. Deciding what needs to be
in the articles and what should be cut is a difficult task. Adding to the work
of getting expert opinions on the findings makes it even more impressive. In
the future, I will make sure to keep all of this in mind when critiquing news
articles.
Sources
Belluck, P.
(2019, January 28). Study Offers Hint of Hope for Staving Off Dementia in Some
People. New York Times. Retrieved February 2, 2019, from
https://www.nytimes.com/2019/01/28/health/dementia-blood-pressure-cognitive-impairment.html
The SPRINT
MIND Investigators for the SPRINT Research Group. Effect of Intensive vs
Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical
Trial. JAMA. 2019;321(6):553–561. doi:10.1001/jama.2018.21442