# Orthostatic Hypotension, Frailty, and Cognitive Impairments Among Older Adults: A Hospital-based Study: Orthostatic Hypotension and Cognitive Frailty in Older Adults

## TL;DR

This study finds that orthostatic hypotension in older adults is linked to frailty and cognitive issues, emphasizing the need for early detection and management.

## Contribution

The study provides new insights into the associations between orthostatic hypotension, frailty, and cognitive impairments in outpatient older adults.

## Key findings

- 33.6% of participants were diagnosed with frailty syndrome.
- 34.4% of participants exhibited cognitive impairments.
- Orthostatic hypotension was significantly associated with frailty and cognitive decline.

## Abstract

Orthostatic hypotension (OH) is a common condition, affecting roughly 20% of
community-dwelling older adults and up to 25% of those in long-term care
facilities. Its presence in older adults has been linked to heightened risks
of frailty, cognitive decline, and increased fall rates, yet few studies
have comprehensively examined these associations in outpatient settings.
This study investigates the relationships between OH, frailty, and cognitive
impairments in older adults attending an outpatient geriatric clinic.

A cross-sectional study was conducted among 250 older adults (aged 60 years
and above) visiting the Outpatient Geriatric Clinic at Firoozabadi Hospital.
Cognitive function was evaluated using the Abbreviated Mental Test Score
(AMTS) and Mini-Cog, while frailty status was determined through the Fried
Frailty Index.

Participants had an average age of 70.72 ± 7.24 years, with ages ranging from
60 to 90. Of the total participants, 38.8% (97) were male, and 61.2% (153)
were female. Average systolic blood pressure (SBP) was 132.04 ± 21.64 mmHg,
and average diastolic blood pressure (DBP) was 79.43 ± 13.01 mmHg. Among
participants, 38% (95) reported a history of falls, and 34% (85) were on
multiple medications (polypharmacy). Notably, 33.6% (84) were diagnosed with
frailty syndrome, and 29.2% (73) exhibited prefrailty. Additionally, 34.4%
(86) of the participants were found to have cognitive impairments.

The study highlights significant associations between orthostatic
hypotension, frailty, and cognitive impairment among older adults. With a
substantial proportion of participants displaying frailty, prefrailty, and
cognitive impairments, these findings underscore the need for early
screening and management of orthostatic hypotension in outpatient settings.
Addressing OH could play a crucial role in mitigating frailty progression,
preserving cognitive function, and reducing fall risk in older adults.
Future research is warranted to explore intervention strategies that may
improve the quality of life and functional outcomes in this vulnerable
population.