Delayed Recovery of Systolic Blood Pressure After Orthostasis Predicts Cognitive Decline in a Large Sample of Community-dwelling Older Adults.

Abstract

Background: With aging, impairments in cardiovascular and autonomic nervous system function render older adults more vulnerable to orthostatic hypotension, increasing the risk of cerebral hypoperfusion which may potentially accelerate cognitive decline. The current study investigated the relationship between orthostatic blood pressure (BP) and cognitive decline in a large sample of older adults.Methods: Data were collected during the first and second waves of The Irish Longitudinal Study on Ageing (TILDA), which took place in 2009-2011 and 2012-2013 respectively. 4,134 adults aged 50 and older were included in the current analysis. Orthostatic BP was measured by beat-to-beat digital plethysmography. Cognitive function was assessed using the Mini Mental State Exam (MMSE) at baseline and follow-up. A multivariate regression model was fitted, adjusting for demographics, depression, health behaviours, exercise, BMI, cholesterol, and medications. Findings: Delayed systolic BP recovery from orthostasis at baseline with associated with a decrease in MMSE score at follow-up (coeff: 0.53, p <.01). Discussion: The failure to return BP to baseline rapidly after standing may impair cerebral blood flow and adversely affect cognition. Further longitudinal study will determine whether these individuals have a greater risk of transitioning to mild cognitive impairment/dementia.