The association of mild cognitive impairment with outpatient visits for hypertension

Abstract

Introduction: Hypertension management is critically important to reduce the risk of conversion of mild cognitive impairment (MCI) to dementia. The degree to which older adults with hypertension and MCI engage in outpatient ambulatory care for hypertension management is unclear.

Methods: Among older adults with hypertension in the Rush Alzheimer's Disease Center (RADC) cohorts (2011 to 2019), we used repeated measures negative binomial regression to evaluate the association between cognitive status (MCI vs no cognitive impairment [NCI]) and number of annual outpatient clinic visits for hypertension evaluation and management (E&M) (primary outcome).

Results: MCI (n = 1013 person-years) was associated with 8% fewer outpatient visits for hypertension versus older adults with NCI (n = 4373 person-years) (relative incidence ratio [RIR] 0.92, p < 0.01).

Discussion: Despite the known adverse cognitive effects of hypertension, older adults with MCI may be less likely to engage in outpatient hypertension management.

Highlights: Fewer outpatient hypertension visits among adults with MCI versus NCI. Fewer primary care hypertension visits among adults with MCI versus without MCI. Need for interventions to engage adults with hypertension and MCI in outpatient care.

Keywords: ambulatory care; hypertension; mild cognitive impairment; outpatient care utilization.