Cognitive Performance in Orthostatic Hypotension: Findings from a Nationally Representative Sample

ObjectivesTo compare the cognitive profile of a population representative sample with orthostatic hypotension (OH) with the profile of a sample without. DesignCross-sectional analysis of a prospective nationally representative population study. SettingThe Irish Longitudinal Study on Ageing (TILDA). ParticipantsTILDA participants (N=5,936; mean age 639, 54% female). MeasurementsOH was defined as a drop of 20mmHg or more in systolic blood pressure or of 10mmHg or more in diastolic blood pressure on standing from a seated position. Cognitive performance was assessed using comprehensive cognitive tests measuring domains of global function, executive function, processing speed, attention, and memory, from which composite standardized scores were computed. Multivariate analysis controlling for potential confounders was performed to compare cognitive performance according to OH status. ResultsPrevalence of OH was 6.1% (95% confidence interval=5.4-6.7%). A significant negative association between OH status and global cognitive function (=-0.21, P=.01) and memory (=-0.26, P=.002) was found in women aged 65 and older after adjustment for demographic characteristics, mental health, cardiovascular disease, and medications (antihypertensive and antipsychotic), but other specific cognitive domains were not affected. ConclusionOH was associated with poorer global cognitive function and poorer memory, independent of potential confounders, in women in a large population-based sample of older adults. Longitudinal studies with concomitant assessment of cerebral perfusion are needed to determine causal relationships.