| Background:Hypertension is the most common chronic disease in the elderly.High blood pressure increases the risk of cognitive impairment and related dementia in older adults.In addition,elderly hypertensive patients with cognitive impairment may be complicated by motor dysfunction,such as balance dysfunction and gait abnormalities,which adversely affect the daily living activities of the elderly.Therefore,early screening,early recognition and early intervention of cognitive and motor function in elderly hypertensive patients are important to delay the progression of cognitive impairment.Purpose and Significance:This study aims to explore the difference in cerebral cortex activation levels between elderly hypertensive patients and healthy elderly people when performing cognitive-walking dual tasks,and to clarify the possible cortical activation changes in elderly hypertensive patients when they cope with cognitive decline in cognitive function by combining cognitive performance and gait parameters.In order to identify and prevent early hypertension patients with cognitive decline in clinical progress,reduce the possibility of progression to cognitive impairment.Methods:In this study,36 participants who met the criteria for inclusion were recruited,including 24 in the elderly hypertension group and 12 in the elderly health group.Sociodemographic data were collected from all participants and blood pressure was measured.All subjects were assessed on a scale of cognitive function,balanced confidence,and depressive status,followed by cognitive and walking function assessments including single cognitive tasks,single walking tasks,and dual tasks monitored by Functional Near-Infrared Spectroscopy(fNIRS)imaging equipment.The cortical oxygenated hemoglobin data of fNIRS were exported from the two groups with cognitive performance and gait parameter data,and the intra-group comparison was performed by paired t-test,and the t-test of two independent samples was used for intergroup comparison.Results:(1)When the two groups performed a single cognitive task,the cognitive performance of the elderly hypertension group was significantly worse(P<0.05),and there was no significant difference in the activation level of cortex in each brain region(P>0.05).It showed that elderly patients with hypertension had significant decline in working memory function.(2)There was no significant difference in gait parameters between the two groups when performing a single walking task(P>0.05),and the activation levels of the left somatosensory cortex,primary motor cortex and bilateral supplementary motor area in the elderly hypertension group were significantly higher(P<0.05).This showed that although there were no obvious abnormalities in gait parameters in elderly hypertensive patients,they needed to recruit more central resources to compensate for the decline in walking function.(3)There was no significant difference between the cognitive performance and gait parameters between the two groups when performing dual tasks(P>0.05),and the left somatosensory cortex and bilateral supplementary motor area showed higher cortical activation levels(P<0.05)when the elderly hypertensive group performed dual tasks.The intra-group comparison showed that the elderly hypertensive group had the same cognitive performance(P>0.05)and worse gait parameters(P<0.05)as single-task when performing dual tasks,and higher levels of cortical activation(P<0.05)appeared in the prefrontal cortex,dorsolateral prefrontal cortex,somatosensory cortex,primary motor cortex and supplementary motor area.These findings suggested that older hypertensive patients were unable to allocate resources efficiently to support more complex task demands,resulting in stronger brain activation,or recruiting more brain resources and more brain network activation.Conclusion:Ederly patients with hypertension cannot effectively allocate brain resources to support more difficult cognitive interference tasks,and may meet more complex task requirements by activating more prefrontal cortex,dorsolateral prefrontal cortex,primary motor cortex,somatosensory cortex,and supplementary motor areas. |
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