Relationship of anxiety-depressive disorders and cognitive dysfunction in patients with arterial hypertension depending on the age and status of physical activity

Abstract

Objective – to determine the level of anxiety and depression, to investigate cognitive functions and the status of physical activity in patients with hypertension, depending on age.Materials and methods. We examined 67 patients with hypertension I–III stage (atherosclerotic plaque and/or myocardial infarction in history). According to age classification (WHO, 2012) patients were randomized into 3 groups: group I – 25 middle-aged patients, group II – 22 elderly patients, group III – 20 patients of senile age. The highest level of education, the total number of education years; duration of arterial hypertension; anthropometric data and the office blood pressure were assessed. We used an individual approach to determine the target level of blood pressure according to the recommendations ESC/ESH 2018. Cognitive functions were evaluated using the MoCA-test and the Clock Drawing Test. The level of anxiety and depression was determined by the results of the Hospital scale of anxiety and depression.Results. According to the data obtained, a statistically greater degree of depression was recorded among eldery patients in comparison with other groups. Only in this group, a higher level of depression was associated with less time that patients spent for regular exercise during the week. Among middle-aged patients with arterial hypertension, the absence of anxiety and depression was detected in 56.0 %. At the same time, in the group of senile age, 75.0 % of patients were diagnosed with manifestations of anxiety and depression of varying severity. It is important to notice that in the group of senile age the median level of anxiety was higher, although nonsignificantly, in comparison with other groups and met the criteria for subclinical anxiety. Results of multivariate correlation analysis showed that a high level of anxiety in middle-aged patients was associated with an earlier age of arterial hypertension verification, as well as with waist circumference increase and the waist/hip circumference ratio. Among elderly patients, a higher level of anxiety was determined in the presence of physical inactivity and among patients of senile age, an increase in anxiety level was associated with a shorter duration of education and a decrease in cognitive functions. Conclusions. The highest level of depression was diagnosed among people of senile age, which was associated with the presence of physical inactivity. The groups did not differ statistically in level of anxiety, however, an increase in its severity in the middle-aged group was associated with an earlier age of hypertension verification and an increase in the degree of abdominal obesity, among elderly patients – with hypodynamia, and in the group of senile age – with a low level of education and the presence of cognitive dysfunctions.