Orthostatic hypotension and cognitive function: the Atherosclerosis Risk in Communities Study.
BACKGROUND
To examine the association between orthostatic hypotension (OH) and cognitive function in middle-aged adults.


METHODS
Participants were 12,702 men and women from the Atherosclerosis Risk in Communities Study. OH was defined as decrease in systolic blood pressure (BP) by > or =20 mm Hg or diastolic BP by > or =10 mm Hg upon standing. At the 2nd and the 4th follow-up examinations, cognitive function was assessed using the Delayed Word Recall Test, Digit Symbol Substitution Test (DSST) and Word Fluency Test (WFT).


RESULTS
After age adjustment, those with OH were more likely to be in the lowest quintile of the DSST (OR = 1.34, 95% CI = 1.12-1.62) and WFT (OR = 1.25, 95% CI = 1.03-1.51) than were those without OH. After adjustment for sociodemographic and cardiovascular risk factors, associations were no longer significant. In age-adjusted models only, OH was associated with increased odds of being in the greatest quintile of decline in DSST score between visits 2 and 4 (OR = 1.28, 95% CI = 1.04-1.58).


CONCLUSIONS
OH was associated with less favorable cognitive function, but this association was largely attributable to demographic and cardiovascular risk factors. Episodic asymptomatic hypotension in middle age may not be an independent cause of cognitive decline. Further study, including emphasis on neuroimaging, is needed.
Rose
Kathryn M
KM
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA. kathryn_rose@unc.edu
Couper
David
D
Eigenbrodt
Marsha L
ML
Mosley
Thomas H
TH
Sharrett
A Richey
AR
Gottesman
Rebecca F
RF
D001741:Black or African American; D050197:Atherosclerosis / Q000453:epidemiology; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011187:Posture; D012306:Risk; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States; D044465:White People