Association of orthostatic hypotension with incident dementia, stroke, and cognitive decline

Abstract

OH assessed in midlife was independently associated with incident dementia and ischemic stroke. Additional studies are needed to elucidate potential mechanisms for these associations and possible applications for prevention.

Effects of orthostatic hypotension on cognition in type 2 diabetes mellitus

“…Edlow and colleagues found that healthy aging does not alter postural changes in frontal cortical perfusion. [21][22][23] We believe these findings add valuable information that may help to clarify previous results with respect to the relationship between OH and cognitive function. Brief episodes of cerebral hypoperfusion caused by sudden drops in BP may lead to hypoxia, with detrimental effects on the central nervous system via mechanisms such as oxidative stress and neuroinflammation.…”

“…OH, as a clinical manifestation of diabetic autonomic neuropathy, is usually irreversible and tough to manage with medications, 20 and is also a significant risk factor for syncope, cognitive decline, falls, cardiovascular disease, stroke, and all-cause morality. [21][22][23] We believe these findings add valuable information that may help to clarify previous results with respect to the relationship between OH and cognitive function. The majority of clinical neuropsychological tests are administered in the seated position.…”

Orthostatic hypotension as a risk factor for longitudinal deterioration of cognitive function in the elderly

“…The effect of OH on cognitive function remains contradictory in the literature depending on the age group, test battery (screening tool versus comprehensive multi-domain testing), covariates and study design. Several cross-sectional studies showed either no association with global cognitive function [3,10,11] or a significant association in terms of global cognitive decline [2,4,[12][13][14]. In a long-term analysis of the Rotterdam study, Wolters et al reported a higher risk of Alzheimer's disease and vascular dementia in participants with OH [15].…”

Orthostatic hypotension as a modifiable risk factor for cognitive impairment: a literature review

“…Во многом это объясняется тем, что женщины живут дольше [8]. В США, например, около 14% пожилых людей страдают деменцией и еще 22% имеют недементные КН [9]. Полагают, что к 2050 г. старение населения приведет к более чем двукратному увеличению общего числа лиц с КН/деменцией [10].…”

“…Средний возраст участников на момент включения составлял 54,5±5,7 года. Для сравнения: средний возраст при включении в Роттердамское исследование [9] -68,5±8,6 года, что объясняется одним из критериев отбора в данное исследование (возраст старше 55 лет). В ис-следовании ARIC при первом визите ОГ диагностирована у 4,7% (у 552) пациентов, в то время как в Роттердамском исследовании -у 18,6%.…”