Orthostatic hypotension and cognitive function: the Atherosclerosis Risk in Communities Study

Area of Science:

• Cardiovascular Health
• Neuroscience
• Gerontology

Background:

• Orthostatic hypotension (OH) is a condition characterized by a significant drop in blood pressure upon standing.
• The relationship between OH and cognitive function in middle-aged adults requires further investigation.

Purpose of the Study:

• To investigate the association between orthostatic hypotension (OH) and cognitive function in a large cohort of middle-aged adults.
• To determine if OH is an independent risk factor for cognitive decline.

Main Methods:

• Utilized data from 12,702 participants in the Atherosclerosis Risk in Communities Study.
• Defined OH as a systolic blood pressure decrease >=20 mm Hg or diastolic blood pressure decrease >=10 mm Hg upon standing.
• Assessed cognitive function using the Delayed Word Recall Test, Digit Symbol Substitution Test (DSST), and Word Fluency Test (WFT) at two follow-up examinations.

Main Results:

• Age-adjusted analyses showed individuals with OH were more likely to perform worse on the DSST and WFT.
• After adjusting for sociodemographic and cardiovascular risk factors, these associations were no longer statistically significant.
• Age-adjusted models indicated OH was associated with a greater decline in DSST scores between study visits.

Conclusions:

• OH showed an association with less favorable cognitive function in middle age.
• This association was primarily explained by demographic and cardiovascular risk factors.
• Episodic asymptomatic hypotension may not be an independent cause of cognitive decline; further research with neuroimaging is recommended.