lowering BP in the elderly reduces mental function

Are we lowering Blood Pressure too much in the elderly.

For many years doctors have strived to bring the blood pressure down to what was considered ideal levels ( 120-130/80-90), no matter how old the patient was.   In the elderly with stiff arteries this is difficult and often requires high doses of multiple drugs to achieve this.

 There is little to no evidence that this is beneficial in the elderly, and the side effects and in many cases falls due to a drop in BP on standing are common. 
Now comes a study from an Italian group published this year in JAMA (click here for abstract) which also shows that lowering BP in the elderly affects their mental function.   They studied 172 people with a mean age of 79 and followed them for 9 months, measuring cognitive function using the Mini Mental score.  Those on BP lowering drugs with a BP lower than 128 systolic had a significant decline in mental function compared with those with BP 129 - 144, and even those above 145mmHg systolic.
So lowering BP to low levels in older people has not been shown to reduce the risk of adverse events, and now we discover it reduces mental function!
The answer - don't try to lower BP with drugs unless the BP is consistently greater than 145-150 systolic