title: Relationship between retinopathy and cognitive impairment among hypertensive subjects. A case-control study in the ankara-pursaklar region.
abstract: BACKGROUND
  The relationship between hypertension and cognitive impairment has been investigated in the literature; several clinical studies suggested a relationship between hypertension and retinopathy.
  
  
  METHODS
  We examined the relationship between the retinopathy status and cognitive functions by using the Mini-Mental State Examination (MMSE) among hypertensive subjects older than 40 years who were admitted to our Family Medicine, Internal Medicine and Ophthalmology clinics. The subjects were categorized into three groups: group 1 = control subjects (n = 39), group 2 = hypertensive patients without retinopathy (n = 32), and group 3 = hypertensive patients with retinopathy (n = 25).
  
  
  RESULTS
  The number of patients with total MMSE scores less than 24 was distributed as follows: group 1: 3 patients (7.7%), group 2: 4 patients (12.5%), and group 3: 14 patients (56%). Hypertension was found to be related with a significant decrease in total MMSE scores in comparison with group 1 subjects (p < 0.001). Furthermore, retinopathy significantly correlated with lower MMSE scores among hypertensive patients (p = 0.001). Compared with group 1, group 3 showed a significant decrease in orientation (p = 0.001), registration (p = 0.001), attention and calculation (p = 0.004), recall (p = 0.009), and total (p < 0.001) MMSE scores. We also found a significant decrease in recall (p = 0.032) and total (p = 0.034) scores in group 3 when compared with group 2. There was a significant decrease in registration (p = 0.002) and total (p = 0.029) MMSE scores in group 2 when compared with group 1. We also observed negative correlations between duration of the disease and orientation (R = -0.597, n = 32, p = 0.001), and between duration of the disease and total (R = -0.495, n = 32, p = 0.006) scores in group 2.
  
  
  CONCLUSIONS
  Hypertension was found to be related with a decline in MMSE scores. This relation was even more significant in the group of hypertensive patients with retinopathy. Thus, we suggest that cognitive tests be routinely used in the follow-up of hypertensive patients.
authors.affiliation: Department of Family Medicine, Fatih University Faculty of Medicine, Ankara, Turkey. oguztekin82@hotmail.com
authors.forename: Oğuz
authors.initials: O
authors.lastname: Tekin
authors.forename: Serdar
authors.initials: S
authors.lastname: Cukur
authors.forename: Cem
authors.initials: C
authors.lastname: Uraldi
authors.forename: Bünyamin
authors.initials: B
authors.lastname: Işik
authors.forename: Adem
authors.initials: A
authors.lastname: Ozkara
authors.forename: Hanifi
authors.initials: H
authors.lastname: Kurtaran
authors.forename: Ferhat
authors.initials: F
authors.lastname: Catal
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ustün
mesh_terms: D016022:Case-Control Studies; D003072:Cognition Disorders / Q000503:physiopathology*; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D009483:Neuropsychological Tests; D012164:Retinal Diseases / Q000503:physiopathology*; D018709:Statistics, Nonparametric