The Relationship Between Orthostatic Blood Pressure Changes And Cognitive Function In Elderly Population

ObjectivesTo evaluate the global and individual cognitive function and explore the relationship between orthostatic blood pressure changes and cognitive function in elderly population.MethodsAll subjects over the age of 60 were selected from Fujian Provincial Hospital in the period between December 2015 and December 2016.413 subjects underwent basic data collection,laboratory inspection and orthostatic blood pressure measurement.Global cognitive function were assessed by montreal cognitive assessment(MoCA)scale.For individual cognitive assessment,the auditory verbal learning test(AVLT)were used to evaluate the memory,the stroop color-word test(CWT)were applied to evaluate the execution ability,the verbal fluency test(VFT)were performed to evaluate the language skills,and the digit span test(DST)were used to assess the attention.The prevalence of cognitive impairment was compared by Chi-square test.Multiple linear regression analysis was applied to explore the relationship between orthostatic blood pressure changes and cognitive function.Results1.In our study,the total score of MoCA was 26.0(23.0,28.0)and the prevalence of cognitive impairment was 49.4%.In the ?80-year-old group group,the cognitive impairment prevalence was higher,while the globle/individual cognitive scores was lower than those in the <80-year-old group,the differences were significant(P<0.05).With the increase of suspine systolic blood pressure(SBP)levels,the prevalence of cognitive impairment increased,while the scores of MoCA and attention decreased gradually(P<0.05).With the increase of pulse pressure levels,the prevalence of cognitive impairment increased,while the scores of MoCA,short delayed recall,long delayed recall,language ability,executive ability and attention decreased gradually(P<0.05).In the hypertensive group,the cognitive impairment prevalence was higher,while the scores of MoCA,short delayed recall,and attention was lower than those in the non-hypertensive group(P<0.05).The cognitive impairment prevalence in the coronary heart disease group was higher,while the scores of MoCA,short delayed recall,and executive ability was lower than those in the non-coronary heart disease group,the differences were significant(P<0.05).There were no statistical differences in cognitive impairment between diabetes and non-diabetes group(P>0.05).2.The cognitive impairment prevalence in OH group(85.2%)was significantly higher than that in the non-OH group(40.7%)(P<0.05).The scores of MoCA,memory ability,language ability,SIE accuray and attention in OH group were significantly lower than those in the non-OH group(P<0.05).3.Multiple linear regression analysis showed that the scores of MoCA,immediate memory,short delayed recall,long delayed recall,language ability,SIE accuray and attention in OH group were lower than those in the non-OH group,the regression coefficients were-2.852,-1.177,-1.916,-2.062,-4.349,-1.158,-0.544(All P<0.05).There was no significant interaction between supine and non-supine hypertension groups(P>0.05).4.After controlling the confounding factors,multiple linear regression analysis showed that SBP changes in 1 min were positively correlated with the scores of MoCA,memory and language ability,SIE accuray and attention.The SBP changes in 3 min were positively correlated with thescores of MoCA,memory and language ability.The diastolic blood pressure(DBP)changes in 1 min were positively correlated with the scores of MoCA,memory and language ability,SIE accuray and attention.The DBP changes in 3 min were positively correlated with the scores of MoCA and language ability(All P<0.05).5.The systolic blood pressure variability were negatively correlated with the scores of MoCA,memory and language ability,and attention(P<0.05).And there was also a negative correlation between diastolic blood pressure variability and immedite recall scores(P<0.05).ConclusionsThe prevalence of cognitive dysfunction in the population of this study was 49.4%,which increased with the increasing in age,supine SBP and pulse pressure levels.The OH group and blood pressure changes widely,cognitive impairment is more obvious,memory and language ability are the main damage.