Relationship between orthostatic hypotension and cognitive impairment in the elderly.
OBJECTIVE
To determine the relationship between orthostatic hypotension (OH) and cognitive function in elderly subjects with memory complaints.


METHODS
We studied the association between cognitive function and OH in 495 consecutive elderly outpatients attending a memory centre. Blood pressure (BP) was measured in a sitting and standing position. We examined cognitive function using a validated comprehensive battery of neuropsychological tests, the cognitive efficiency profile (CEP) assessing the main cognitive areas. Subjects were classified into 4 categories according to their cognitive status: normal cognitive function, mild cognitive impairment (MCI), Alzheimer's disease (AD) or vascular dementia (VaD).


RESULTS
In this population, 76±8 years of age (women 72%), 18% had normal cognitive function, 28% had MCI, 47% AD, and 7% VaD. Hypertension was observed in 74% of patients. OH was present in 14% of subjects (n=69). After adjustment for age, education level, systolic BP, diastolic BP, weight, and antihypertensive drugs, subjects with OH had worse cognitive function than those without OH (CEP score 50±24 vs 56±22, p<0.05). Moreover, a significant relationship was observed between OH and cognitive status (normal cognitive function, MCI, AD, or VaD). OH was present in 22% in VaD subjects, 15% in AD subjects, 12% in MCI subjects and 4% in normal control subjects (p<0.01 for overall test).


CONCLUSIONS
Our results showed an association between OH and cognitive impairment and emphasize the need for longitudinal studies designed to evaluate the nature of the relationship between OH and cognitive decline.
Mehrabian
Shima
S
Université Paris Descartes, Department of Geriatrics, Hôpital Broca, 54/56 Rue Pascal, 75013 Paris, France.
Duron
Emmanuelle
E
Labouree
Florian
F
Rollot
Florence
F
Bune
Alex
A
Traykov
Latchezar
L
Hanon
Olivier
O
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000150:complications*; D015140:Dementia, Vascular / Q000150:complications*; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications*; D008297:Male; D008568:Memory; D008569:Memory Disorders / Q000150:complications*; D009483:Neuropsychological Tests; D012307:Risk Factors