Abstract P171: Smaller Body Mass Index is Associated With Mild Cognitive Impairment in Elderly Hypertensive Patients

Abstract

Backgrounds: In elderly hypertensive patients, it might be important to pay attention to cognitive function when achieving aggressive blood pressure goal; therefore we evaluated factors associated with cognitive impairment in elderly hypertensive patients. Methods: We performed Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in 209 elderly hypertensive patients who were evaluated frailty (Aged > 65 years, Male 38.3 %). Dementia was diagnosed as MMSE scores < 23 and/or anti-dementia drug use; mild cognitive impairment (MCI), MoCA<24 points and MMSE > 24 points. Results: Mean age was 78.6±6.2 years. There were 84.2 % of patients who were taking antihypertensive drug. Clinic blood pressure was 133.2±17.6 / 74.3±11.9 mmHg and body mass index (BMI) was 23.7±7.6 kg/m 2 . MMSE score was 27.0±3.8 and MoCA was 21.1±4.9 points. There were 53.0 % of patients with MCI; 12.9 % with dementia. Patients with MCI and dementia had lower BMI than those without (MCI group, BMI=23.2±3.5 kg/m 2 ; dementia group, 23.4±2.7 kg/m 2 ; no MCI or dementia group, 24.8±3.9 kg/m 2 ; P=0.012). The risk of MCI increased by 13.2 % per smaller BMI of 1 kg/m 2 (P=0.006); that of dementia increased by 18.6 % per smaller BMI of 1 kg/m 2 (P=0.055) after adjustment for age, gender, antihypertensive drugs use, diabetes, dyslipidemia, smoking habit, alcohol drinking, history of stroke, and systolic and diastolic blood pressure. Patients with the lowest quartile of BMI (< 21.34 kg/m2) had 3.82 (95%CI 1.42-10.27) times greater risk of MCI and had 7.59 (95%CI 1.22-47.27) times greater risk of dementia than those with highest quartile of BMI (> 25.69 kg/m2). Conclusion: In elderly hypertensive outpatients who were suspected of frailty, smaller BMI was associated with presence of MCI and dementia, suggested that we needed to decide optimal blood pressure level carefully in lean hypertensive patients.