Postural hypotension and EEG variables predict cognitive decline:Results from a 5-year follow-up of healthy elderly women
S. Elmstahl
Bok Engelsk 1997
| Utgitt | 1997
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| Omfang | Side 180- 187
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| Opplysninger | Quantified electroencephalographic activity (EEC) has been used tostudy normal ageing and dementia. Few studies have describedlongitudinal changes in the very old. A cognitive decline has beendescribed in subjects with white-matter lesions and hypertension butthe association with hypotension is unclear. Our aim was to study thepredictive value of quantified EEG for the development of cognitivedecline and associations with postural hypotension. Participants:Thirty-three healthy women aged 75-95 years, with no signs ofcerebrovascular disease, dementia or acute illness at baselineexamination took part in a longitudinal 5-year follow-up study. Thewomen were recruited from a random selection using the MunicipalRegistry. Quantified EEG was assessed twice and recorded on a Siemens-Elema connected to a Biological Banker. The medical andneuropsychological examination was conducted twice. Dementia wasclassified according to DSM criteria. The assessment included Mini-Mental Scale Examination (MMSE), spatial and vocabulary tests. Bloodpressure was measured in supine position and an orthostatic test wasperformed with continuous ECG recording. Seven women (cases)developed cognitive decline at the 5-year follow-up, defined as newlydeveloped MMSE <27 and dementia symptoms. Low beta activity atbaseline predicted development of cognitive decline. The women whoremained healthy at follow-up showed an increase of alpha and thetaactivity. The cases had a higher orthostatic blood pressure fahduring tilting at baseline (16 mm Hg) than the controls (1 mm Hg, p <0.01). The orthostatic reaction was correlated with increased levelsof theta and alpha activity at follow-up (r = -0.47 to -0.52 p <0.01). Low beta activity predicts for cognitive decline in theelderly and an orthostatic blood pressure reaction is a risk factorfor cognitive decline.
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