Orthostatic intolerance predicts mild cognitive impairment: incidence of mild cognitive impairment and dementia from the Swedish general population cohort Good Aging in Skåne

Clin Interv Aging. 2014 Nov 20:9:1993-2002. doi: 10.2147/CIA.S72316. eCollection 2014.


Introduction: Contradictory results have been reported on the relationship between orthostatic hypotension (OH) and mild cognitive impairment (MCI).

Objective: To study the incidence of MCI and dementia and their relationship to OH and subclinical OH with orthostatic symptoms (orthostatic intolerance).

Study design and setting: This study used a prospective general population cohort design and was based on data from the Swedish Good Aging in Skåne study (GÅS-SNAC), they were studied 6 years after baseline of the present study, with the same study protocol at baseline and at follow-up. The study sample comprised 1,480 randomly invited subjects aged 60 to 93 years, and had a participation rate of 82% at follow-up. OH test included assessment of blood pressure and symptoms of OH.

Results: The 6-year incidence of MCI was 8%, increasing from 12.1 to 40.5 per 1,000 person-years for men and 6.9 to 16.9 per 1,000 person-years for women aged 60 to >80 years. The corresponding 6-year incidence of dementia was 8%. Orthostatic intolerance during uprising was related to risk for MCI at follow-up (odds ratio [OR] =1.84 [1.20-2.80][95% CI]), adjusted for age and education independently of blood pressure during testing. After stratification for hypertension (HT), the corresponding age-adjusted OR for MCI in the non-HT group was 1.71 (1.10-2.31) and 1.76 (1.11-2.13) in the HT group. Among controls, the proportion of those with OH was 16%; those with MCI 24%; and those with dementia 31% (age-adjusted OR 1.93 [1.19-3.14]).

Conclusion: Not only OH, but also symptoms of OH, seem to be a risk factor for cognitive decline and should be considered in the management of blood pressure among the elderly population.

Keywords: elderly; epidemiology; orthostatic blood pressure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Blood Pressure
  • Cognitive Dysfunction / epidemiology*
  • Dementia / epidemiology*
  • Female
  • Health Behavior
  • Humans
  • Hypotension, Orthostatic / epidemiology*
  • Incidence
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Orthostatic Intolerance / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sex Factors
  • Sweden / epidemiology