Dependence of cognitive profile of multimorbid elderly patients with hypertension from charlson comorbidity index

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Abstract

Population aging entails an increased incidence of age-associated diseases that are risk factors for cognitive impairment.

The aim: to еvaluate cognitive function (CF) of multimorbid patients aged ≥ 60 years with arterial hypertension (AH) depending on the Charlson comorbidity index.

Material and methods. Study participants (n = 330) were divided into 3 groups depending on the Charlson index: group 1 – 0–4 points (n = 69, median age 72 years), group 2 – 5–7 points (n = 182, median age 80 years), group 3 – ≥ 8 points (n = 79, median age 82 years). All patients were assessed for QF using a range of cognitive tests.

Results. The Montreal Cognitive Assessment Scale (MoCA) revealed statistically significant differences between groups 1 and 2, 1 and 3 (p = 0.032 and p < 0.001, respectively; maximum in group 1, minimum in group 3), on the Mini-Mental State Examination (MMSE) – between groups 1 and 3 (27 and 26 points respectively, p = 0.014), on the Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog) – between groups 1 and 2 (12 and 15 points respectively, p = 0.011). Group 3 patients scored statistically significantly lower on the Boston Test compared to groups 1 and 2 (p₁₋₂₋₃ = 0.008). In the literal association’s subtest, group 3 patients named statistically significantly fewer words compared to patients in groups 1 and 2 (p = 0.002 and p = 0.006, respectively). In the Digit Symbol Substitution Test, statistically significant differences were recorded between groups 1 and 3 (p = 0.022). Statistically significant differences between the groups (p₁₋₂₋₃ < 0.001) were also found when evaluating the results of the maximum digit series memorization test.

Conclusion. The obtained results indicate a direct influence of the number of certain comorbidities and age of patients, which reflects the Charlson comorbidity index, on the severity of cognitive impairment in polymorbid elderly and senile patients with AH.

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About the authors

Olga D. Ostroumova

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia; I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)

Author for correspondence.
Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-0795-8225
SPIN-code: 3910-6585

MD, Dr. Sci. (Medicine), professor, head of the Department of therapy and multimorbid pathology named after academician M.S. Vovsi, professor of the Department of clinical pharmacology and propaedeutics of internal diseases

Russian Federation, 125993, Moscow, 2/1 build. 1 Barrikadnaya St.; 119048, Moscow, 8 build. 2 Trubetskaya St.

Kantemir K. Dzamikhov

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia

Email: kantemir.dk@mail.ru
ORCID iD: 0000-0002-8941-7018
SPIN-code: 9603-5881

MD, postgraduate student of the Department of therapy and multimorbid pathology named after academician M.S. Vovsi

Russian Federation, 125993, Moscow, 2/1 build. 1 Barrikadnaya St.

Alexey I. Kochetkov

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia

Email: ak_info@list.ru
ORCID iD: 0000-0001-5801-3742
SPIN-code: 9212-6010

MD, PhD (Medicine), associate professor, associate professor of the Department of therapy and multimorbid pathology named after academician M.S. Vovsi

Russian Federation, 125993, Moscow, 2/1 build. 1 Barrikadnaya St.

Tatyana M. Ostroumova

I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)

Email: t.ostroumova3@gmail.com
ORCID iD: 0000-0003-1499-247X

MD, PhD (Medicine), assistant at the Department of nervous diseases and neurosurgery

Russian Federation, 119048, Moscow, 8 build. 2 Trubetskaya St.

Vera R. Shastina

Hospital for War Veterans No. 2 of the Department of Healthcare of Moscow

Email: ShastinaVR@zdrav.mos.ru
ORCID iD: 0000-0002-2933-7876
SPIN-code: 7230-9602

MD, PhD (Medicine), chief physician of Hospital for War Veterans No. 2 of the Department of Healthcare of Moscow

Russian Federation, 109472, Moscow, 168 Volgogradsky Avenue

Marina A. Lyakhova

Hospital for War Veterans No. 2 of the Department of Healthcare of Moscow

Email: ShastinaVR@zdrav.mos.ru

MD, head of the Department of palliative care

Russian Federation, 109472, Moscow, 168 Volgogradsky Avenue

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