New study focuses on hypertension interventions for people with cognitive impairment

Virgil McDill | July 5, 2023

With grant funding from the National Institutes of Health (NIH), researchers at the University of Minnesota School of Public Health (SPH) will seek to improve the treatment of uncontrolled high blood pressure, also called hypertension, among people living with early stage Alzheimer’s disease (AD) and Alzheimer’s disease related dementia (ADRD), as well as people with mild cognitive impairment (MCI).

Hypertension is a common risk factor for cognitive impairment, and frequently occurs with dementia. The condition is also widespread and worsening — particularly among older adults. Although self-measured blood pressure monitoring has been shown to successfully manage hypertension, this treatment method is challenging for people living with cognitive impairments. The current study aims to address this challenge by focusing instead on caregivers.

The current research builds on mGlide, an existing SPH heart-health study that gives people a home machine to measure blood pressure. However, this new study, which researchers are calling “mGlide-Care,” will focus on the caregivers of people with MCI and mild dementia to help control hypertension. Specifically, mGlide-Care will provide mobile technology and training to caregivers to manage a daily, technology-based, self-care intervention, which would be highly challenging for people living with dementia.

Kamakshi Lakshminarayan

“Previous research has shown that optimal hypertension management for older adults should be evidence-based and patient-specific,” said Kamakshi Lakshminarayan, SPH professor and principal investigator on the project. “We believe mGlide-Care can achieve both of these objectives by supplying caregivers with the equipment and training they need to partner with the patient’s health care team and hence make the best, individualized decisions for the people in their care.”

The research will have three key aims:

  1. Conduct focus groups to help adapt mGlide to develop mGlide-Care. The focus groups with key stakeholders — including people with early stage AD/ADRD and MCI, family caregivers, primary care providers, geriatricians, and clinical pharmacists — will gather input on the perceived utility and potential barriers of caregivers adopting technology-mediated care of hypertension.
  2. Development of a feasibility pilot study. Researchers will test mGlide-Care against usual care methods in a 6-month pilot study of 75 participants with uncontrolled hypertension and early stage AD/ADRD or MCI.
  3. Training junior investigators. This grant supports the mentoring and training of junior investigators. The goal is to prepare the next generation of investigators for their own major scientific advances and independent research careers.

In their application for the grant, the researchers noted that the research aligns with the National Institutes on Aging’s (NIA) goals of developing and adapting evidence-based interventions for persons with AD/ADRD and improving their access to technology-facilitated care.

“In meeting these goals, this research will enhance health equity and reduce existing healthcare disparities,” said Lakshminarayan.

The study will be completed in June of 2028. Results will be shared via publications, presentations to the scientific as well as lay communities.

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