Hypertension and Cognitive Impairment: Kahrizak Elderly Study

Abstract

Keywords: cognitive impairment, diastolic high blood pressure, elderly, systolic high blood pressure s u m m a r y Background: Dementia is a major cause of cognitive impairment in the elderly. Numerous studies have investigated the association between hypertension and cognitive disorders in elderly persons, with inconsistent results. The goal of the study was to investigate the association between hypertension at baseline and cognitive impairment after 24 months' follow-up in the elderly residents of the Kahrizak Charity Foundation (KCF) in Iran. Methods: There were 211 elderly residents of KCF aged 65 years or older with a Mini Mental State Examination (MMSE) score greater than 10. The MMSE score was assessed at the end of the study. Blood pressure was measured in all of the participants at the beginning of study. Data were compared between hypertensive and normotensive patients. Results: A total of 63.5% of patients had impaired cognition (61% and 63.9% in normotensive and hypertensive patients, respectively). Cross sectional analysis of baseline data in a multiple regression model has revealed that diastolic high blood pressure was a risk factor for cognitive impairment even after adjustment for confounding factors (odds ratio: 2.42, 95% CI: 1.01-5.78). In the cohort follow-up analysis, the relative risk of cognitive impairment for patients aged 75 years or older with final diagnosis of hypertension was 0.72 (0.57e0.92). The relative risk of patients with systolic high blood pressure and history of hypertension was 19% and 10%, respectively, which was lower than normotensive group but such differences were not significant. Conclusions: High systolic blood pressure in very old persons may have a preventive effect on development and progression of cognitive impairment. However, diastolic high blood pressure perhaps may be a risk factor for cognitive impairment in elderly persons.

The Prevalence of Cognitive Impairment among Older Adults in Jamaica

“…Our findings of variables predicting an association with cognitive impairment build upon previous work among older adults (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). In this study, self-reported hypertension was not a significant predictor of cognitive impairment.…”

“…In this study, self-reported hypertension was not a significant predictor of cognitive impairment. The literature reports conflicting results regarding the influence of hypertension and gender on cognitive impairment (29,(43)(44)(45). Gender, though significant in bivariate analysis, was not found to be an independent predictor in this study when the other variables were introduced in the regression model.…”

“…Cognitive impairment and dementia have been associated with rural dwellers (16), increased rates of hospitalization (17,18), increased risk for falls (19,20), increased prevalence of fear of falling (21,22), diabetes mellitus (23,24), depression (17,25), and dependence in activities of daily living [ADL] (26). There are conflicting studies on the association of gender and hypertension with cognitive impairment (27)(28)(29). The last nationally representative study on cognitive impairment in Jamaica was completed over two decades ago and reported a prevalence of 14.1% (30).…”

Incidence and Risk Profile of Dementia in the Regions of Middle East and North Africa

“…Besides this, in Iran as well the risk of dementia due to hypertension remains modest (1.4 times, 95% CI 1.0–2.2) [27]. Just like elsewhere, the risk of dementia in MENA may also depend upon the type of hypertension (systolic or diastolic) and whether it is controlled or not [53]. …”

Smoking After Age 65 Years and Mortality: The Kangwha Cohort Study

“…Some studies have suggested that smoking might be a risk factor for the development of dementia 19,20 . Several other studies have suggested that smoking improves cognitive performance 21 .…”