Université Paris Descartes, Department of Geriatrics, Hôpital Broca, 54/56 Rue Pascal, 75013 Paris, France.
J Neurol Sci. 2010 Dec 15;299(1-2):45-8. doi: 10.1016/j.jns.2010.08.056. Epub 2010 Sep 19.
To determine the relationship between orthostatic hypotension (OH) and cognitive function in elderly subjects with memory complaints.
We studied the association between cognitive function and OH in 495 consecutive elderly outpatients attending a memory centre. Blood pressure (BP) was measured in a sitting and standing position. We examined cognitive function using a validated comprehensive battery of neuropsychological tests, the cognitive efficiency profile (CEP) assessing the main cognitive areas. Subjects were classified into 4 categories according to their cognitive status: normal cognitive function, mild cognitive impairment (MCI), Alzheimer's disease (AD) or vascular dementia (VaD).
In this population, 76±8 years of age (women 72%), 18% had normal cognitive function, 28% had MCI, 47% AD, and 7% VaD. Hypertension was observed in 74% of patients. OH was present in 14% of subjects (n=69). After adjustment for age, education level, systolic BP, diastolic BP, weight, and antihypertensive drugs, subjects with OH had worse cognitive function than those without OH (CEP score 50±24 vs 56±22, p<0.05). Moreover, a significant relationship was observed between OH and cognitive status (normal cognitive function, MCI, AD, or VaD). OH was present in 22% in VaD subjects, 15% in AD subjects, 12% in MCI subjects and 4% in normal control subjects (p<0.01 for overall test).
Our results showed an association between OH and cognitive impairment and emphasize the need for longitudinal studies designed to evaluate the nature of the relationship between OH and cognitive decline.
确定体位性低血压（OH）与有记忆主诉的老年患者认知功能之间的关系。
我们研究了 495 例连续就诊于记忆门诊的老年患者的认知功能与 OH 之间的关系。血压（BP）在坐位和立位时进行测量。我们使用经过验证的全面神经心理学测试组合（认知效率剖面图[CEP]，评估主要认知领域）检查认知功能。根据认知状态将受试者分为 4 类：正常认知功能、轻度认知障碍（MCI）、阿尔茨海默病（AD）或血管性痴呆（VaD）。
在该人群中，年龄为 76±8 岁（女性占 72%），18%具有正常认知功能，28%患有 MCI，47%患有 AD，7%患有 VaD。74%的患者患有高血压。14%的受试者（n=69）存在 OH。在校正年龄、教育程度、收缩压、舒张压、体重和降压药物后，OH 患者的认知功能较无 OH 患者差（CEP 评分 50±24 与 56±22，p<0.05）。此外，还观察到 OH 与认知状态之间存在显著相关性（正常认知功能、MCI、AD 或 VaD）。VaD 患者中 OH 发生率为 22%，AD 患者为 15%，MCI 患者为 12%，正常对照组为 4%（总体检验 p<0.01）。
我们的结果表明 OH 与认知障碍之间存在关联，并强调需要进行旨在评估 OH 与认知衰退之间关系性质的纵向研究。
