Analysis of treatment for improving cognitive dysfunction in elderly patients with hypertension

Geriatric hypertension is a key risk factor for mild cognitive impairment (MCI) and no MCI interventions utilize community elderly service resources.

To analyze lifestyle factors' effects on hypertensive patients' cognition and evaluate the cognitive impairment intervention course's improvement in those with MCI.

A total of 280 hypertensive patients aged 60-80 years from Huacao Community were retrospectively enrolled between May 2024 and July 2025, among whom 64 were diagnosed with MCI. These 64 patients were split into two groups: conventional antihypertensive treatment (n=32) and conventional treatment + elderly service center cognitive intervention (combined group, n=32). Primary outcomes included MCI prevalence in hypertensive patients, associations between lifestyle and cognitive function and MoCA scores and blood pressure (BP) fluctuations in MCI patients. Secondary outcomes included MMSE, activities of daily living (ADL), short-form 36 (SF-36) and medication adherence scale-8 (MMAS-8) scores and adverse events.

The MCI prevalence among elderly hypertensive patients in Huacao community was 22.9%. Smoking, excessive alcohol, insufficient physical activity and high fat/sugar/salt diet were MCI risk factors in these patients (P=0.014, 0.030, 0.041, 0.018). After treatment, the combined group had significantly larger increases in MoCA, MMSE and SF-36 scores than the conventional group (P=0.013, 0.010, <0.001), narrower systolic and diastolic BP fluctuations (P<0.001, 0.002), a greater decrease in ADL total score (P=0.031) and a higher MMAS-8 score (P=0.019). No significant difference in adverse event incidence was observed between the two groups (P=0.351).

Elderly hypertensive patients in Huacao community have high MCI prevalence, closely tied to lifestyle. The center's cognitive intervention course can effectively boost their cognition and fit into these patients' community management system.