Natasha Tipnis, Girish Rajadhyaksha, Meghav Shah
  MNJ, pp. 98-103  


Background: Hypertension and dementia increase parallel to age.

Objective: The purpose of this study was to study the effect of hypertension on cognition before age-related cognitive impairment begins to set in.

Methods: In this prospective, cross-sectional study conducted at a tertiary-care centre between May 2014 and December 2015, 300 (150 hypertensives and 150 normotensives) participants were compared. Patients were divided into groups according to age, gender, education, and duration of hypertension. The Hindi Mini-Mental State Examination (HMMSE) was used to detect cognitive impairment.

Results: Overall, occurrence of cognitive impairment was 53 (35.3%) in hypertensives and 37 (24.7%) in normotensives. Below 60 years male and female hypertensives and normotensives had comparable mean HMMSE scores, although not statistically significant. Sixty years and above male and female normotensives achieved slightly higher HMMSE scores than male and female hypertensives, however this finding was statistically significant (p=0.002) for males ≥60 years. Among the cognitive domains, orientation to time (p=0.009), registration (p=0.018), recall (p=0.031), and 3 step command (p=0.014) were statistically different between hypertensives and normotensives. Periventricular white matter ischemia was discovered in 8 (5.3%) and 2 (1.3%) hypertensives and normotensives, respectively.

Conclusion: Although hypertension was not statistically associated with cognitive decline in hypertensives <60 years, hypertensives >60 years showed statistical significance with cognitive decline. Furthermore, specific cognitive domains such as orientation to time, registration, recall, and 3 step command displayed statistical significance for cognitive decline. Future prospective, large-scale studies are warranted to investigate these and other possible associations.


Age; cognitive impairment; dementia; Hindi mini-mental state exam; hypertension

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Rivarti AW, Herawati L, Hidayati HB Exercise prevents age-related memory decline: The role of neurotrophic factors. Malang Neurology Journal; 2020. 6(2):88–94.


Sharifi F, Hedayat M, Fakhrzadeh H, et al. Hypertension and cognitive impairment: Kahrizak elderly study. Int J Gerontol; 2011. 5(4):212–6.


Wysocki M, Luo X, Schmeidler J, et al. Hypertension is associated with cognitive decline in elderly people at high risk for dementia. Am J Geriatr Psychiatry; 2012. 20(2):179–87.

DOI: 10.1097/JGP.0b013e31820ee833

Peters R, Beckett N, Forette F, et al. Incident dementia and blood pressure lowering in The Hypertension In The Very Elderly Trial Cognitive Function Assessment (HYVET-COG): A double-blind, placebo controlled trial. Lancet Neurol; 2008. 7(8):683–9. DOI: 10.1016/S1474-4422(08)70143-1

Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol; 2005. 4(8):487–99.

DOI: 10.1016/S1474-4422(05)70141-1

Mossello E, Pieraccioli M, Nesti N, et al. Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs. JAMA Intern Med; 2015. 175(4):578–85.

DOI: 10.1001/jamainternmed.2014.8164

Sabayan B, Westendorp RG Blood pressure control and cognitive impairment—why low is not always better. JAMA Intern Med; 2015. 175(4):586–7.

DOI: 10.1001/jamainternmed.2014.8202

Folstein MF, Folstein SE, McHugh PR Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res; 1975. 12(3):189–98. DOI: 10.1016/0022-3956(75)90026-6

Ganguli M, Ratcliff G, Chandra V, et al. A Hindi version of the MMSE: The development of a cognitive screening instrument for a largely illiterate rural elderly population in India. Int J Geriatr Psychiatry; 1995. 10(5):367–77.


Gaidhane S, Gaidhane AM, Zahiruddin QS, et al. Essential hypertension and cognitive function in elderly. Int J Geriatr Psychiatry; 2014; 31-2.

Knopman D, Boland L, Mosley T, et al. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology; 2001. 56(1):42–8. DOI: 10.1212/wnl.56.1.42

Gottesman RF, Schneider AL, Albert M, et al. Midlife hypertension and 20-year cognitive change: the atherosclerosis risk in communities neurocognitive study. JAMA Neurol; 2014. 71(10):1218–27.

DOI: 10.1001/jamaneurol.2014.1646

Devraj SV, Ola V, Meena B, et al. Cognitive function in elderly population: An urban community based study in north-west Rajasthan. Journal of Indian Academy of Clinical Medicine; 2014. 1587–90.

Singh VB, Kumar H, Devraj R, et al. To study the prevalence of mild cognitive impairment (MCI) and its subtypes in elderly person≥ 60 years of age and to study the epidemiological aspect of MCI. International Journal of Medical and Health Research; 2015. 1(3):62–7.

Pariama AM, Ranimpi YY, Setiawan A Subjective well-being and healthy behaviour of elderly with dementia alzheimer's (a phenomenological study). Malang Neurology Journal.2020; 6(2):82–7.


Muela HC, Costa‐Hong VA, Yassuda MS, et al. Hypertension severity is associated with impaired cognitive performance. J Am Heart Assoc; 2017. 6(1):e004579. DOI: 10.1161/JAHA.116.004579

Antony J, Nakulan A, Shiny J Association between socio-demographic profile and severity of cognitive impairment in elder patients presenting with new onset of psychiatric symptoms: A cross sectional study. International Journal of Research in Medical Sciences; 2019. 7(7):2519–23.

DOI: 10.18203/2320-6012.ijrms20192579

Dufouil C, Alperovitch A, Tzourio C Influence of education on the relationship between white matter lesions and cognition. Neurology; 2003. 60(5):831–6. DOI: 10.1212/01.wnl.0000049456.33231.96

Scarmeas N, Stern Y Cognitive reserve: Implications for diagnosis and prevention of Alzheimer’s disease. Curr Neurol Neurosci Rep; 2004. 4(5):374–80.

DOI: 10.1007/s11910-004-0084-7

Hubert HB, Feinleib M, McNamara PM, et al. Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Framingham Heart Study. Circulation; 1983. 67(5):968–77.

DOI: 10.1161/01.cir.67.5.968


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