Is Mini-Mental Score Examination Scoring a New Predictor of Uncontrolled Hypertension? (original) (raw)
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Dementia and Geriatric Cognitive Disorders Extra, 2017
Aims: We compared the role of central blood pressure (BP), ambulatory BP monitoring (ABPM), home-measured BP (HMBP) and office BP measurement as risk markers for the development of mild cognitive impairment (MCI). Methods: 70 hypertensive patients on combination medical therapy were studied. Their mean age was 64.97 ± 8.88 years. Eighteen (25.71%) were males and 52 (74.28%) females. All of the patients underwent full physical examination, laboratory screening, echocardiography, and office, ambulatory, home and central BP measurement. The neuropsychological tests used were: Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). SPSS 19 was used for the statistical analysis with a level of significance of 0.05. Results: The mean central pulse pressure values of patients with MCI were significantly (p = 0.016) higher than those of the patients without MCI. There was a weak negative correlation between central pulse pressure and the results from the MoCA and MMSE...
Assessment of Cognitive Dysfunctions in Essential Hypertensives- a Crosssectional Study
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Arterial hypertension and blood pressure level are associated with cognitive impairment. Susceptible people, especially cerebral ischaemia are having more severe cognitive impairment. Elevated blood pressure for long term contributes to cognitive impairment in later life. The aim of this study is to determine the cognitive dysfunctions in essential hypertensives. MATERIALS AND METHODS It was a descriptive cross-sectional study that was conducted among 300 subjects who were diagnosed as essential hypertensives were chosen by simple random sampling from the inpatient and outpatient facility of Department of Medicine, Father Muller's Medical College. The socio-demographic data of hypertensives was collected on a semi-structured proforma. Patients were assessed for cognitive dysfunctions using the Standardised Mini Mental Status Examination (SMMSE) and Brief Cognitive Rating Scale (BCRS). Data was analysed using SPSS 18 software. RESULTS Mean age group of patients was 51.67 years, majority of the patients were males and were urban domicile. Majority of patients had primary level of education. Majority of patients had positive relation between cognitive deficiency and their hypertensive status was measured using Standardised Mini Mental Status Examination (SMMSE) and Brief Cognitive Rating Scale (BCRS). CONCLUSION The study showed that there are significant cognitive deficits in hypertensives. SMMSE (Standardised Mini Mental Status Examination) and BCRS (Brief Cognitive Rating) Scales were used to measure Cognitive deficits, which were very closely related to hypertension.
The Egyptian Heart Journal, 2015
Background: Hypertension has been shown to carry an increased risk not only for cerebrovascular stroke but also for cognitive impairment and dementia. Ambulatory blood pressure monitoring (ABPM) is a good predictor of cardiac, renal, and cerebral disease in middle-aged and older people with hypertension. Patients and methods: The study included 77 elderly (mean age: 69 years) subjects. Based on the history of hypertension, office blood pressure, and ABPM, patients were classified into 2 groups, Group I: 22 persons as a control group and Group II: 55 hypertensive patients. The hypertensive group was further sub classified by using data of ABPM into dippers and non-dippers. Both groups were subjected to clinical examination, laboratory analysis, ABPM, Transthoracic Echocardiographic Examination, brain magnetic resonance imaging (MRI) and mini-mental state examination (MMSE) of their cognitive function. Results: There was a statistically significant positive correlation between the cerebral MRI score and each of the average 24-h systolic, diastolic and mean arterial blood pressure, average morning systolic, diastolic, mean arterial blood pressure, average night systolic, diastolic and mean arterial blood pressure. There was also a statistically significant negative correlation between the MMSE
American Journal of Epidemiology, 1997
The authors examined the association of blood pressure with cognitive function as assessed by the Mini-Mental State Examination (MMSE) in a community-based Swedish cohort of 1,736 people aged 75-101 years. Age, sex, education, antihypertensive medication use, heart disease, and stroke were considered as covariates. Multiple linear regression analysis indicated that both systolic and diastolic blood pressure, measured in 1987-1989, were positively and significantly related to baseline MMSE score; baseline systolic pressure was also positively and significantly related to follow-up MMSE score, measured after an average period of 40.5 months among subjects who were not taking antihypertensive medication at baseline. Furthermore, in the nontreated group, multiple logistic regression showed that individuals with a baseline systolic pressure less than 130 mmHg had an odds ratio of 1.88 (p = 0.05) for follow-up cognitive impairment (MMSE score <24) compared with those whose systolic pressure was 130-159 mmHg. An increased but not statistically significant risk of cognitive impairment was associated with high blood pressure (systolic pressure £180 mmHg or diastolic pressure s95 mmHg) only in persons taking antihypertensive medication at baseline. Subjects with systolic pressure of 160-179 mmHg tended to be at lower risk of cognitive impairment. These results may support the view that a certain blood pressure level, particularly a systolic pressure of at least 130 mmHg, is important to the maintenance of cognitive functioning in the very old. They also suggest that severe hypertension that is not well controlled (systolic pressure >180 mmHg or diastolic pressure >95 mmHg) is still a threat to cognitive function in this age group. However, the use of blood pressure measurements made at a single visit and the relatively short follow-up period should be considered when interpreting these results.
Neurocognitive disorder in hypertensive patients. Heart–Brain Study
Hipertensión y Riesgo Vascular, 2018
The relation between hypertension and cognitive impairment is an undisputable fact. The aims of this study were to determine the prevalence of cognitive impairment in hypertensive patients, to identify the most affected cognitive domain, and to observe the association with different parameters of hypertension and other vascular risk factors. A multicentre study was carried out, and 1281 hypertensive patients of both genders and ≥21 years of age were included. Data on the following parameters were obtained: cognitive status (Minimal Cognitive Examination), behavioural status (Hospital Anxiety and Depression Scale), blood pressure, anthropometry, and biochemical profile. The average age was 60.2 ± 13.5 years (71% female), and the educational level was 9.9 ± 5.1 years. Global cognitive impairment was seen
Neuropsychological deficits in arterial hypertension
Acta Neurologica Scandinavica, 1986
Sixty subjects with uncomplicated essential hypertension and 60 matched normal subjects were submitted to neuropsychological tests in order to establish whether some impairment of cognitive functions can be evidenced even in those hypertensive subjects that are in this respect asymptomatic on standard examination and interview. The hypertensive subjects obtained significantly poorer results than normotensive subjects on memory, visuo-motor and performance tests. In the control group, the classic negative correlation pattern between age and scores was observed, while in the patient group this correlation could be confirmed only in a few tests. Subgrouping of patients according to hypertension duration and treatment showed that the impairment of cognitive functions manifested itself very early and did not tend to progress within 6-10 years of hypertension duration.
Hypertension Severity Is Associated With Impaired Cognitive Performance
Journal of the American Heart Association, 2017
Most evidence of target-organ damage in hypertension (HTN) is related to the kidneys and heart. Cerebrovascular and cognitive impairment are less well studied. Therefore, this study analyzed changes in cognitive function in patients with different stages of hypertension compared to nonhypertensive controls. In a cross-sectional study, 221 (71 normotensive and 150 hypertensive) patients were compared. Patients with hypertension were divided into 2 stages according to blood pressure (BP) levels or medication use (HTN-1: BP, 140-159/90-99 or use of 1 or 2 antihypertensive drugs; HTN-2: BP, ≥160/100 or use of ≥3 drugs). Three groups were comparatively analyzed: normotension, HTN stage 1, and HTN stage 2. The Mini-Mental State Examination, Montreal Cognitive Assessment, and a validated comprehensive battery of neuropsychological tests that assessed 6 main cognitive domains were used to determine cognitive function. Compared to the normotension and HTN stage-1, the severe HTN group had wo...
Current Medical Research and Opinion, 2008
Background and aims: The aim of the COGNIPRES study was to analyze the prevalence of cognitive impairment in hypertensive individuals over 60 years of age, treated in primary care centres in the context of routine clinical practice. Degree of blood pressure control and treatment compliance, as well as other possible factors that influence cognitive function, were also evaluated. Methods: An epidemiological, multicentre cross-sectional study was made. Demographic, clinical, therapeutic and blood pressure data for the first three hypertensive patients aged over 60 years seen in the primary care centre, and for the first patient visited at home by the physician were recorded. The study was carried out by 477 physicians in 333 primary care centres throughout Spain. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE), and therapeutic compliance was assessed using the Haynes-Sacket and Morisky-Green tests. Results: Of 1579 patients included in the study, 12.3% (95%CI 10.7-14.0) (n ¼ 195) had cognitive impairment. This was significantly associated with patients over 80 years of age (OR 4.97; 95%CI 2.98-8.29), exclusive home care (OR 1.84; 95%CI 1.19-2.83), anxiety (OR 1.84; 95%CI 1.19-2.83), stroke or transient ischemic attack (OR 4.37; 95%CI 2.81-6.78), Parkinson's disease (OR 8.15; 95%CI 2.54-26.12), essential tremor (OR 2.25; 95%CI 1.34-3.79), uncontrolled blood pressure (OR 0.60; 95%CI 0.39-0.94) and poor treatment compliance (OR 0.53; 95%CI 0.37-0.75). Overall, 28.3% of the patients showed controlled blood pressure, and 33.6% showed poor adherence to antihypertensive treatment. Conclusions: In this study, the prevalence of cognitive impairment in hypertensive patients aged over 60 years was 12.3%. Less than a third of the patients had good blood pressure control. Compliance with therapy and good control of blood pressure are associated with better MMSE scores.