Orthostatic hypotension carries increased risk of dementia in seniors

Older adults with orthostatic hypotension (OH) are at heightened risk of dementia, a study reports. OH can also speed up progression of cognitive decline.

The study used data from the population-based cohort study Swedish National Study on Aging and Care in Kungsholmen. A total of 2,532 participants (age ≥60 years, 62.6 percent women) who were free of dementia at baseline were included. All of them underwent regular examination over 12 years.

Of the participants, 615 had OH (defined as a decrease of ≥20/10 mm Hg in systolic/diastolic blood pressure upon standing) at baseline. There were 322 participants who developed dementia during the entire follow-up period.

In multivariable flexible parametric survival models, OH conferred a 40-percent increase in dementia risk (adjusted hazard ratio [aHR], 1.40, 95 percent confidence interval [CI], 1.10–1.76) and a 15-percent increase in the risk of cognitive impairment but no dementia (CIND; aHR, 1.15, 95 percent CI, 0.94–1.40). CIND was defined as scoring ≥1.5 units below age group-specific means in at least one cognitive domain.

Furthermore, among participants who had CIND, OH was associated with a 54-percent higher risk of progression to dementia (aHR, 1.54, 95 percent CI, 1.05–2.25).

When OH was stratified into asymptomatic and symptomatic, results for asymptomatic OH were consistent with that for overall OH. Specifically, asymptomatic OH contributed to a risk increase in dementia and CIND progression to dementia.

On the other hand, symptomatic OH was only associated with CIND progression to dementia.