Prevalence and predictors of cognitive impairment among hypertensive patients on follow up at jimma university medical center, jimma, southwest Ethiopia

Abstract

BACKGROUND: Cognitive impairment is a condition when a person suffers from recalling, learning new things, concentrating, or making decisions that affect their everyday life. Hypertension is highly prevalent disease affecting around one billion individuals worldwide and 55.2% African population Hypertension has been associated with reduced abstract reasoning (executive dysfunction), slowing of mental processing speed and memory deficits, The blood vessels in the prefrontal subcortical areas are often affected by sever hypertension, which can affect the ability to make executive decisions and other brain function . OBJECTIVES: To determine the prevalence and predictor of cognitive impairment among hypertensive patients on follow up at Jimma University Medical Centre, Jimma, Southwest Ethiopia, 2018 METHODS: Institution based cross sectional study design was employed from June 01 to July 15, 2018 among 279 hypertensive patients on follow-up at Jimma University Medical Centre chronic clinic, Jimma, Ethiopia. The data collection tools contained sociodemographic characteristics, Mini Mental State Examination (MMSE), substance use, medical history, blood pressure and somatic measurements such as body weight and height. The MMSE scale was used to measure cognition level. The collected data were cleared and entered into SPSS Version 20.0 for analysis. The association between the independent variables and the outcome variable (cognition level) was analyzed using logistic regression model. A p-value of <0.05 was considered statistically significant in the final model. RESULTS: Out of the 279 hypertensive patients included in this study, 142 (50.9%) were male and the remaining proportion was female. The mean age ± SD of the participants was 53.15 + 11.544 years with a range of 20 to 86 years. Nearly two-third (178, 63.8%) of the participants were aged between 40 and 59 years. The prevalence of cognitive impairment (less than 24 out 30 on MMSE scale) in this study was 108 (38.7%). Cigarette smoking (AOR=4.302, 95% CI: 1.106-16.734), physical inactivity (AOR=2.05, 95% CI: 1.05-5.97), triglycerides level > 200 mg/dl (AOR=4.48, 95% CI: 1.898-10.587) and Stage I (AOR=5.125; 95% CI: 2.052-12.802) and Stage II hypertension (AOR=3.434; 95% CI: 1.498-7.871) were significantly associated with cognitive level. CONCLUSION: Cognitive impairment was relatively common in the study population. The study revealed that cigarette smoking, lack of physical activity, high triglyceride levels and Stage I and II HTN were significantly associated with cognitive impairment.