Abstract-We studied a cohort of 1408 older subjects to explore whether postural changes in blood pressure (BP; defined as orthostatic hypo-or hypertension) can predict the onset of cognitive deterioration. Orthostatic hypotension was defined as a drop of 20 mm Hg in systolic or 10 mm Hg in diastolic BP and orthostatic hypertension as a rise of 20 mm Hg in systolic BP. Orthostatic BP values were grouped into quintiles for secondary analyses. Two cognitive assessments were considered:(1) cognitive impairment, that is, Mini-Mental State Examination scores ≤24/30, and (2) cognitive decline (CD), that is, a 3-point decrease in Mini-Mental State Examination score from the baseline to the follow-up. At the baseline, the prevalence of orthostatic hypotension and hypertension was 18.3% and 10.9%, respectively. At the follow-up (4.4±1.2 years), 286 participants were found cognitively impaired and 138 had a CD. Using logistic regression analysis adjusted for potential baseline confounders, participants with orthostatic hypertension were at significantly higher risk of CD (odds ratio =1.50; 95% confidence intervals =1.26-1.78). Neither orthostatic hypotension nor orthostatic hypertension raised the risk of developing a cognitive impairment. Using quintiles of orthostatic BP values, we found that both decreases and increases in systolic and diastolic BP raised the risk of CD, but not of cognitive impairment. In conclusion, we found that orthostatic hypertension predicts the onset of CD, but not of cognitive impairment in the elderly, whereas orthostatic hypotension predicts neither of these conditions. Further studies are needed to confirm our findings. Correspondence to Nicola Veronese, Department of Medicine-DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2-35128, Padova, Italy. E-mail ilmannato@gmail.com or Chiara Curreri, Department of Medicine-DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2-35128 Padova, Italy. E-mail chiaracurreri@icloud.com Orthostatic Changes in Blood Pressure and Cognitive Status in the ElderlyThe Progetto Veneto Anziani Study Methods Data Source and SubjectsThis work was based on data obtained for the Progetto Veneto Anziani (Pro.V.A.) study, an observational cohort study of communitydwelling subjects aged ≥65 years residing in Camposampiero and Rovigo (2 towns in northern Italy), who were enrolled without any specific exclusion criteria. 16 Baseline visits were conducted between October 1995 and November 1997. To avoid any sampling bias, the initial sample was randomly divided into 3 (Camposampiero) and 4 (Rovigo) mutually exclusive subsets that were balanced for age and sex distribution. A random sample was selected from the first subset, and the remaining subsets were set aside. As part of the sampling strategy, age and sex were stratified to maintain a male-to-female ratio of 2:3, to oversample the oldest subjects and thereby obtain reliable estimates of conditions with low prevalence rates, and to recruit a sizable proportion of disabled individuals. Th...

Difficulties with fine motor skills are common in older adults, and assessing them may help to identify early signs of dementia, subjects at high risk to develop cognitive decline, and individuals who can be referred to specialists.

Involvement of older adults in childcare activities seems to lower the risk of cognitive impairment in both genders and to prevent onset or worsening of depression particularly in older men. Copyright © 2017 John Wiley & Sons, Ltd.

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