Relationship between Orthostatic Hypotension and Cognitive Dysfunction in the Elderly

Liu Kai; Chen Ying; Han Kunyuan; Lin Daoyong; Zhou Xiaoli; Jiang Fan; Tong Shan

doi:10.3969/j.issn.1672-1349.2017.15.033

Abstract：Objective To explore the relationship between orthostatic hypotension (OH) and cognitive function in elderly patients with memory impairment.Methods We enrolled 495 cases aged above 60 years old memory loss or loss of patients, first admission blood pressure measurements were in quiet ward off ten minutes after lying position detection, then patient stand up and in the same arm measured again a blood pressure, and using a mercury sphygmomanometer.The cognitive function was assessed using Cognitive Efficiency Profile (CEP).The subjects were divided into 4 groups:the Alzheimer's disease group (AD), vascular dementia group (VaD), mild cognitive impairment group (MCI), and normal control group.Results The incidence of OH was about 14% (n=69/495).The incidence of OH was 22% in patients with VaD, 15% in patients with AD, about 12% in patients with MCI, 4% in the control group (P<0.01).Age, education level, sitting systolic/diastolic pressure, body weight, anti hypertension drug use by corrected found with orthostatic hypotension was closely related to (OR=0.24;95% CI:0.12-0.73;P= 0.007).The scores of CEP in OH group were lower than that in non-OH group (50±24 vs 56±22, P<0.05).The decline of systolic blood pressure in the station in AD group and VaD group were greater than that in normal cognitive function group (-7.9 mmHg±16.0 mmHg vs -0.7 mmHg±14.0 mmHg,P=0.02;-5.5 mmHg±14.0 mmHg vs-0.7 mmHg±14.0 mmHg,P=0.01).The decline in diastolic blood pressure after standing was not significantly associated with dementia (OR=0.98;95% CI:0.93-1.03;P=0.427).Conclusion Our results indicate that OH is closely related to cognitive dysfunction in the elderly.