Orthostatic hypotension predicts cognitive impairment in the elderly: findings from a cohort study

Objective To explore the relationship between orthostatic hypotension (OH) and cognition impairment (CI) in the elderly. Methods Forty-four OH patients who visited our hospital due to dizziness, vertigo and fatigue during January 2009 to December 2011 were enrolled in the exposed group (OH group), and 88 healthy elderly paired in 1∶2 were enrolled in the control group (NOH group). The socio-demographic data and cognition-related factors between the two groups were collected at baseline; cognitive function was assessed using mini-mental state examination (MMSE) 4 years after baseline of the present study. Results The overall incidence of CI was 14.0% among the 114 subjects who completed the follow-up assessment. Significant difference in CI incidence was noted between OH group (23.7%) and NOH group (9.2%, χ2=4.399, P=0.036). The analysis by age showed that there was no significant difference in CI incidence between the OH group (15.4%) and NOH group (9.1% ) among the elderly younger than 70 years; the CI incidence in OH group (41.7% ) was significantly higher than that in NOH group (9.3%) among the elderly older than 70 years (χ2=5.935, P= 0.016). Conclusion OH is a risk factor of CI among the elderly older than 70 years. Key words: Postural hypotension; Cognition impairment; The eldly; Cohort study