{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:38:23Z","timestamp":1792647503883,"version":"4.5.0"},"reference-count":64,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">In cognitive impairment and dementia, where biological functions are disrupted, nonlinear dynamics may reflect dysregulation of blood pressure (BP) that might not be captured by linear variability. We investigated whether nonlinear dynamics of 24\u2010hour BP variability are associated with cognitive impairment and dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a cross\u2010sectional analysis of 4854 participants from 3 population\u2010based studies. Raw 24\u2010hour ambulatory BP recordings were structured as time series to quantify nonlinear variability using sample entropy, detrended fluctuation analysis, and Poincar\u00e9 measures. High entropy and Poincar\u00e9 values with low detrended fluctuation analysis suggest irregular dynamics, whereas the opposite pattern indicates a predictable BP system. Neurological outcomes included Mini\u2010Mental State Examination, mild cognitive impairment (n=212), and dementia (n=111).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">The mean age was 67.6\u00b17.89\u2009years (61.0% women). Higher 24\u2010hour systolic BP entropy and Poincar\u00e9 measures were associated with lower Mini\u2010Mental State Examination; adjusted\u2010mean Mini\u2010Mental State Examination estimates ranged from \u22120.119 (95% CI, \u22120.184 to \u22120.053) to \u22120.035 (95% CI, \u22120.060 to \u22120.010). These measures were also associated with higher odds for prevalent mild cognitive impairment (odds ratios [OR] \u22651.41) and dementia (ORs ranged from 1.32 [95% CI, 1.08\u20131.60] to 2.36 [95% CI, 1.49\u20133.74]). Lower detrended fluctuation analysis was related to dementia (OR, 1.64 [95% CI, 1.01\u20132.68]). Sex, antihypertensive medication, and measures of linear variability did not modify the association between nonlinear variability and cognitive outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Nonlinear 24\u2010hour BP dynamics were associated with cognitive impairment and dementia. Nonlinear patterns of irregular 24\u2010hour variability may represent a form of BP dysregulation relevant to dementia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051805","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:25:03Z","timestamp":1792149903000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear 24\u2010Hour Blood Pressure Dynamics in Cognitive Impairment and Dementia"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1382-1153","authenticated-orcid":false,"given":"Jesus D.","family":"Melgarejo","sequence":"first","affiliation":[{"name":"University of Texas Rio Grande Valley (UTRGV)","place":["Harlingen, USA"]},{"name":"University of Texas Health Science Center San Antonio, School of Medicine","place":["San Antonio, 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