P5659Atrial fibrillation causes cognitive impairment-which cognitive domains are affected?

Abstract Introduction Hypertension is an important modifiable risk factor related to cognitive dysfunction. Data suggest that atrial fibrillation (AF) is also associated with an increased risk of cognitive decline, independent of stroke history. Few studies focus on the effect of AF on specific cognitive domains. Purpose We aimed in this study to investigate the prevalence of cognitive dysfunction among hypertensive patients with atrial fibrillation and to evaluate the impact of atrial fibrillation on the affected cognitive domains. Methods In the present paper, we included 488 consecutive hypertensive patients admitted to a Cardiovascular Rehabilitation Clinic aged between 37–93 years (mean age: 68±10 years; 51.84% female; 48.15% male). Diagnosis of AF was based on 12 lead ECG. All types of AF (paroxysmal, persistent and permanent) were included. The prevalence of atrial fibrillation in our sample was 23.77% (n=116), on admission mean heart rate was 76±16 bpm and mean blood pressure 137/82 mmHg (±19/11 mmHg). After routine clinical assessment all participants completed the Montreal Cognitive Assessment (MoCA) test used for the detection of mild cognitive impairment. Depression as a confounding factor on cognitive performances was detected with the shortened 13 items form of Beck Depression Inventory (BDI-13). We compared MoCA scores of the group of patients with atrial fibrillation with scores from the group in sinus rhythm. Statistical analysis was performed with the IBM SPSS v.20 program. Results Impairment in cognitive functions was revealed among hypertensive patients in sinus rhythm vs. with atrial fibrillation according to MoCA in 66.1% (n=246) vs. 81.9% (n=95). Cognitive scores were significantly lower in the atrial fibrillation group vs. patients in sinus rhythm: MoCA: 21.74 vs. 22.97 (p=0.016). The prevalence of depression in the two groups was not statistically different, AF 52.58% vs. 55.34% patients in sinus rhythm (p=0.89). Analysing MoCA's cognitive domains, patients with atrial fibrillation had significantly lower scores in visuospatial/executive (3.09 vs. 3.52 p=0.005), language (1.59 vs. 1.85 p=0.019) and abstraction (1.18 vs. 1.41 p=0.005) domains. Conclusions The prevalence of cognitive impairment is higher in patients with atrial fibrillation. Atrial fibrillation may have an impact on the most complex cognitive functions as visuospatial/executive, language and abstraction. Acknowledgement/Funding Funding for the study was provided by the Hungarian Academy of Science, contract nr. 0346/26.02.2016.

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The Impact of Vascular Risk Factors on Post-stroke Cognitive Impairment: The Nor-COAST Study

Frontiers in Neurology ◽

10.3389/fneur.2021.678794 ◽

2021 ◽

Vol 12 ◽

Author(s):

Stina Aam ◽

Mari Nordbø Gynnild ◽

Ragnhild Munthe-Kaas ◽

Ingvild Saltvedt ◽

Stian Lydersen ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Coronary Heart Disease ◽

Cognitive Impairment ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Z Score ◽

Cognitive Domains ◽

Post Stroke ◽

The Impact

Introduction: Post-stroke cognitive impairment (PSCI) is common, but evidence on the impact of vascular risk factors is lacking. We explored the association between pre-stroke vascular risk factors and PSCI and studied the course of PSCI.Materials and Methods: Vascular risk factors were collected at baseline in stroke survivors (n = 635). Cognitive assessments of attention, executive function, memory, language, and the Montreal Cognitive Assessment (MoCA) were performed at 3 and/or 18 months post-stroke. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). PSCI was measured with global z; MoCA z-score; and z-score of the four assessed cognitive domains. Mixed-effect linear regression was applied with global z, MoCA z-score, and z-scores of the cognitive domains as dependent variables. Independent variables were the vascular risk factors (hypertension, hypercholesterolemia, smoking, diabetes mellitus, atrial fibrillation, coronary heart disease, previous stroke), time, and the interaction between these. The analyses were adjusted for age, education, and sex. There were between 5 and 25% missing data for the variables for PSCI.Results: Mean age was 71.6 years (SD 11.7); 42% were females; and the mean NIHSS score at admittance was 3.8 (SD 4.8). Regardless of vascular risk factors, global z, MoCA, and all the assessed cognitive domains were impaired at 3 and 18 months, with MoCA being the most severely impaired. Atrial fibrillation (AF) was associated with poorer language at 18 months and coronary heart disease (CHD) with poorer MoCA at 18 months (LR = 12.80, p = 0.002, and LR = 8.32, p = 0.004, respectively). Previous stroke was associated with poorer global z and attention at 3 and 18 months (LR = 15.46, p < 0.001, and LR = 16.20, p < 0.001). In patients without AF, attention improved from 3 to 18 months, and in patients without CHD, executive function improved from 3 to 18 months (LR = 10.42, p < 0.001, and LR = 9.33, p = 0.009, respectively).Discussion: Our findings indicate that a focal stroke lesion might be related to pathophysiological processes leading to global cognitive impairment. The poorer prognosis of PSCI in patients with vascular risk factors emphasizes the need for further research on complex vascular risk factor interventions to prevent PSCI.

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Cognitive Function and Atrial Fibrillation: From the Strength of Relationship to the Dark Side of Prevention. Is There a Contribution from Sinus Rhythm Restoration and Maintenance?

Medicina ◽

10.3390/medicina55090587 ◽

2019 ◽

Vol 55 (9) ◽

pp. 587 ◽

Cited By ~ 5

Author(s):

Emanuele Gallinoro ◽

Saverio D’Elia ◽

Dario Prozzo ◽

Michele Lioncino ◽

Francesco Natale ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cognitive Function ◽

Sinus Rhythm ◽

Cognitive Decline ◽

Cognitive Dysfunction ◽

Population Aging ◽

Cerebral Hypoperfusion ◽

Dark Side ◽

White Matter Hyperintensity ◽

The Impact

Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia with an increasing prevalence over time mainly because of population aging. It is well established that the presence of AF increases the risk of stroke, heart failure, sudden death, and cardiovascular morbidity. In the last two decades several reports have shown an association between AF and cognitive function, ranging from impairment to dementia. Ischemic stroke linked to AF is a well-known risk factor and predictor of cognitive decline. In this clinical scenario, the risk of stroke might be reduced by oral anticoagulation. However, recent data suggest that AF may be a predictor of cognitive impairment and dementia also in the absence of stroke. Cerebral hypoperfusion, reduced brain volume, microbleeds, white matter hyperintensity, neuroinflammation, and genetic factors have been considered as potential mechanisms involved in the pathogenesis of AF-related cognitive dysfunction. However, a cause-effect relationship remains still controversial. Consequently, no therapeutic strategies are available to prevent AF-related cognitive decline in stroke-free patients. This review will analyze the potential mechanisms leading to cognitive dysfunction in AF patients and examine the available data on the impact of a sinus rhythm restoration and maintenance strategy in reducing the risk of cognitive decline.

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Pulmonary Disorders

The Oxford Handbook of Adult Cognitive Disorders ◽

10.1093/oxfordhb/9780190664121.013.9 ◽

2019 ◽

pp. 166-189

Author(s):

Sachelle Ruickbie ◽

Charles Sharp ◽

James W. Dodd

Keyword(s):

Cognitive Impairment ◽

Lung Disease ◽

Cognitive Dysfunction ◽

Chronic Lung Disease ◽

Management Strategies ◽

World Health ◽

Future Research ◽

Relative Contribution ◽

Increased Risk ◽

The Impact

The World Health Organization estimates that approximately 40 million people currently live with dementia and that this number will increase to 80 million during the next 20 year. It is therefore a global priority to identify any modifiable or treatable risk factors for the disease. Mild cognitive impairment (MCI) is associated with a 5–10 percent annual conversion rate to dementia but is also considered a potentially reversible state. There is a maturing body of evidence indicating that impaired lung function and chronic lung disease are independent determinants of cognitive impairment in the elderly, including MCI, suggesting not just an association but also a possible causal relationship. People living with lung disease may well be at increased risk of cognitive dysfunction and brain pathology. Researchers face a number of complexities in studying this association. These might be usefully summarized in three ways: understanding the impact of shared etiology for both respiratory disease and cognitive impairment, understanding the relative contribution of factors more prevalent in both cognitive impairment and lung disease, and identifying effects specific to chronic lung disease. This chapter considers the evidence of cognitive dysfunction among the major pulmonary disorders and the relative contribution of shared and disease-specific factors. It also considers how recent advances in neuroimaging may provide insight into the mechanisms at play and therefore direct future therapeutic targets. Finally, it considers management strategies to reduce the risk of cognitive dysfunction in chronic lung disease and defines areas for future research.

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Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

Scientific Reports ◽

10.1038/s41598-021-83367-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

So-Ryoung Lee ◽

Kyung-Do Han ◽

Eue-Keun Choi ◽

Seil Oh ◽

Gregory Y. H. Lip

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Body Mass ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver ◽

Increased Risk ◽

The Impact

AbstractWe evaluated the association between nonalcoholic fatty liver disease (NAFLD) and incident atrial fibrillation (AF) and analyzed the impact of NAFLD on AF risk in relation to body mass index (BMI). A total of 8,048,055 subjects without significant liver disease who were available fatty liver index (FLI) values were included. Subjects were categorized into 3 groups based on FLI: < 30, 30 to < 60, and ≥ 60. During a median 8-year of follow-up, 534,442 subjects were newly diagnosed as AF (8.27 per 1000 person-years). Higher FLI was associated with an increased risk of AF (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.046–1.060 in 30 ≤ FLI < 60, and HR 1.115, 95% CI 1.106–1.125 in FLI ≥ 60). In underweight subjects (BMI < 18.5 kg/m2), higher FLI raised the risk of AF (by 1.6-fold in 30 ≤ FLI < 60 and by twofold in FLI ≥ 60). In normal- and overweight subjects, higher FLI was associated with an increased risk of AF, but the HRs were attenuated. In obese subjects, higher FLI was not associated with higher risk of AF. NAFLD as assessed by FLI was independently associated with an increased risk of AF in nonobese subjects with BMI < 25 kg/m2. The impact of NAFLD on AF risk was accentuated in lean subjects with underweight.

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The Association between Physical Activity and Selected Parameters of Psychological Status and Dementia in Older Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147549 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7549

Author(s):

Angelika Cisek-Woźniak ◽

Kinga Mruczyk ◽

Rafał W. Wójciak

Keyword(s):

Mental Health ◽

Physical Activity ◽

Cognitive Impairment ◽

Cognitive Functioning ◽

Cognitive Functions ◽

Protective Factor ◽

The Elderly ◽

Regular Physical Activity ◽

Psychological Status ◽

The Impact

Physical activity has an unquestionable impact on broadly understood human health. One interesting issue related to this is the importance of movement on mental health and cognitive functioning. Research shows that regular physical activity improves the cognitive functioning of adults and people with mental disorders. Regular physical activity can be an important and powerful protective factor in cognitive impairment and dementia in the elderly, and exercise is an important non-pharmacological treatment for mild cognitive impairment or neurodegenerative diseases. This study aims to present the impact of physical activity on selected cognitive functions in physically active women over 60 years of age. The research was carried out in a group of 110 generally healthy women from the area of western Poland over 60 years of age, who were divided into four groups based on the intensity of their physical activity. A pedometer (sport watch) and a physical activity diary were used to measure physical activity. Body Mass Index was assessed. Selected cognitive functions were assessed using the MMSE test, motor and psychomotor skills were measured, and Luria’s auditory memory test and recall test, a clock drawing test, and a GDS test were performed. There were statistically significant relationships between the level of physical activity and the effectiveness of cognitive processes. These results show that about 5000 steps a day is enough to see a positive effect on the mental health and cognitive functioning of this group of the elderly population. The women had an average BMI of 28.1 ± 4.7. BMI, indicating an overweight condition (over 30 kg/m2), was observed in 31% of women. The results of this study lead the authors to conclude that physical activity positively influences cognitive function and can be recommended for all seniors who do not have other serious comorbidities that would prevent them from playing sports.

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Depletion of acetate-producing bacteria from the gut microbiota facilitates cognitive impairment through the gut-brain neural mechanism in diabetic mice

Microbiome ◽

10.1186/s40168-021-01088-9 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Hong Zheng ◽

Pengtao Xu ◽

Qiaoying Jiang ◽

Qingqing Xu ◽

Yafei Zheng ◽

...

Keyword(s):

Cognitive Impairment ◽

Gut Microbiota ◽

Cognitive Functions ◽

Neural Mechanism ◽

Fecal Microbiota ◽

Protective Role ◽

Fecal Microbiota Transplant ◽

Memory Impairments ◽

The Impact

Abstract Background Modification of the gut microbiota has been reported to reduce the incidence of type 1 diabetes mellitus (T1D). We hypothesized that the gut microbiota shifts might also have an effect on cognitive functions in T1D. Herein we used a non-absorbable antibiotic vancomycin to modify the gut microbiota in streptozotocin (STZ)-induced T1D mice and studied the impact of microbial changes on cognitive performances in T1D mice and its potential gut-brain neural mechanism. Results We found that vancomycin exposure disrupted the gut microbiome, altered host metabolic phenotypes, and facilitated cognitive impairment in T1D mice. Long-term acetate deficiency due to depletion of acetate-producing bacteria resulted in the reduction of synaptophysin (SYP) in the hippocampus as well as learning and memory impairments. Exogenous acetate supplement or fecal microbiota transplant recovered hippocampal SYP level in vancomycin-treated T1D mice, and this effect was attenuated by vagal inhibition or vagotomy. Conclusions Our results demonstrate the protective role of microbiota metabolite acetate in cognitive functions and suggest long-term acetate deficiency as a risk factor of cognitive decline.

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The role of epicardial fat tissue in atrial fibrillation onset in patients with hypertension

European Heart Journal ◽

10.1093/ehjci/ehaa946.0365 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Tarzimanova ◽

V.I Podzolkov ◽

M.V Pisarev ◽

R.G Gataulin ◽

K.A Oganesian

Keyword(s):

Atrial Fibrillation ◽

Plasma Concentration ◽

Sinus Rhythm ◽

Epicardial Fat ◽

Funding Source ◽

Fat Tissue ◽

Hypertensive Patients ◽

Group I ◽

Epicardial Fat Tissue ◽

Group Ii

Abstract Aim To study the influence of epicardial fat tissue (EFT) on atrial fibrillation (AF) occurrence in hypertensive patients. Materials and methods The study included 195 patients with hypertension aged from 38 to 72 years (mean age was 61.5±1.8 years). All patients were divided into two groups: group I included 95 hypertensive patients with paroxysmal AF; 100 patients with hypertension in sinus rhythm were enrolled into group II. Echocardiography was performed to evaluate the thickness of EFT in a parasternal long-axis view. The EFT volume was assessed with computed tomography (CT) scan. The plasma concentration of tissue inhibitor of metalloproteinase-1 (TIMP-1) and metalloproteinase-9 (MMP-9) was measured to evaluate the myocardial fibrosis process. Results There was no significant difference between the studied groups of patients in body mass index: 34.43±1.2 kg/m2 in group I vs 31.97±1.67 kg/m2 in the group II. Waist circumference was significantly higher in group I in comparison with the group II patients: 118.9±3.3 cm vs 110.2±1.4 cm, respectively (p=0.038). EFT thickness was significantly higher in patients with paroxysmal AF (11.6±0.8 mm) in comparison with the patients in sinus rhythm (8.6±0.4 mm) (p<0.001). In group I patients a significant increase of EFT volume (4.6±0.4) in comparison with II group (3.5±0.25) (p=0.002) was noted. A significant positive correlation was revealed in hypertensive patients with paroxysmal AF between EFT volume and left atrial (LA) volume (r=0.7, p=0.022). Also, the plasma concentrations of TIMP-1 and MMP-1 were significantly higher in patients with paroxysmal AF and hypertension. There was a strong positive correlation between EFT volume and plasma concentration of TIMP-1 (r=0.72; p=0.01) and between the EFT volume and the LA volume (r=0.7, p=0.022) in group I patients. Multivariate regression analysis revealed the significant influence of increased EFT thickness more than 10 mm (prevalence ratio (PR) 4.1; 95% CI 1.1; 15.6) and EFT volume more than 6 ml (PR 3.7; 95% CI 1.0; 14.2) on AF occurrence. Conclusion Increased EFT thickness (more than 10 mm) and EFT volume (more than 6 ml) are predictors of AF onset in hypertensive patients. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): The complex subject of the Department

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Vztah mezi presbyakuzí a poruchou kognitivních funkcí ve stáří PDF uzamčeno English info

Otorinolaryngologie a foniatrie ◽

10.48095/ccorl2021223 ◽

2021 ◽

Vol 70 (4) ◽

pp. 223-233

Author(s):

Jakub Fuksa ◽

Milan Profant ◽

Martin Chovanec ◽

Josef Syka

Keyword(s):

Hearing Loss ◽

Cognitive Impairment ◽

Hearing Aids ◽

Cognitive Functions ◽

Auditory Information ◽

Ageing Population ◽

Published Evidence ◽

Age Related ◽

Keywords Dementia ◽

Increased Risk

Age-related hearing loss, presbycusis, is one of the most frequent sensory impairments in the ageing population. It is associated with pathologies of both inner ear and the central parts of the auditory system. Intact cognitive functions are necessary for the proper processing of complex auditory information. Since the beginning of the 80s, there is an increasing amount of evidence linking presbycusis to cognitive impairment and increased risk of dementia. The exact cause, which connects these two pathologies, is still unknown, although there are several hypotheses with various levels of evidence available. This review aims to describe the role of cognitive functions in the auditory processing, to summarize published evidence for a relationship between the hearing loss and cognitive impairment with a possible mechanism, which would explain this link. In addition, we discuss specific features of cognitive assessment in a person with hearing loss and describe the effect of hearing loss treatment, e. g. with hearing aids, cochlear implant and cognitive-hearing training on cognitive functions. Keywords: dementia – hearing loss – presbycusis – cognitive decline

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Call for Emergency Room Guidelines to Identify Hyperthyroid Patients Prior to Contrast Imaging

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1885 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A922-A923

Author(s):

Sandhya Bassin ◽

Louis F Amorosa

Keyword(s):

Atrial Fibrillation ◽

Emergency Room ◽

Definitive Treatment ◽

Graves Disease ◽

Contrast Imaging ◽

Iodinated Contrast ◽

Increased Risk ◽

History Of ◽

The Impact ◽

Hyperthyroid Patients

Abstract Background: Thyrotoxicosis can be mistaken for conditions such as atrial fibrillation and pulmonary embolism (PE) given the nonspecific symptoms of fatigue, palpitations, and dyspnea. Patients often undergo further imaging on presentation to the emergency room (ER), many of which use iodine for contrast. This can put patients at increased risk for iodine induced hyperthyroidism and delay definitive treatment in patients with Graves’ disease, the most common cause of hyperthyroidism. Clinical Case: A 53-year-old male with history of hyperthyroidism, atrial fibrillation, and prior PE presented with palpitations to the ER. He developed worsening dyspnea on exertion and palpitations over the last three days. He was unable to afford his medications, including methimazole, for the last nine months. In the ER he was in atrial fibrillation with rapid ventricular response. Due to concern for PE, he underwent a CTA with contrast, which was negative. His physical exam was notable for a diffusely enlarged goiter. His labs showed low TSH <0.01 (norm 0.35-5.50mIU/L) and high free T4 >7.77 (norm 0.9-1.8ng/dL). TSH stimulating antibodies were elevated at 1.9 (norm <1.3 TSI index), consistent with Graves’ hyperthyroidism. Endocrinology was then consulted for severe thyrotoxicosis, initially treating the patient with PTU and propranolol. The patient was transitioned to methimazole and continued propranolol on discharge. Since he was given contrast, plan was for repeat thyroid uptake scan and iodine ablation in 3 months. However, patient was not compliant with medications, resulting in readmission for thyrotoxicosis 3 months later. Conclusion: This case highlights the impact of increased use of contrast in imaging in hyperthyroid patients. Hyperthyroid patients are at an increased risk for emboli. However, iodine can cause contrast-induced hyperthyroidism and delay definitive treatment of Graves’ disease. As almost half of thyrotoxic patients receive iodinated contrast prior to an endocrine consultation, endocrinologists should work with emergency physicians to develop a set of guidelines to identify at risk populations for hyperthyroidism (1). We advocate for urgent thyroid testing in patients with new onset atrial fibrillation, a history of Graves’ disease, specific symptoms of Graves’, or those taking thyrotoxic-inducing medications. This will assist in determining if patients should receive a prophylactic dose of anti-thyroid medication prior to iodinated contrast imaging. These guidelines can help prevent contrast induced hyperthyroidism and disruptions in treatment of Graves’ while still imaging patients for other diagnoses on the differential. Reference: (1) Giacomini A, et al. Urgent thyroid-stimulating hormone testing in emergency medicine: A useful tool? J Emerg Med. 2015;49(4):481-487.

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The Condition of Cognitive Functions in Patients with Stage 1 and Stage 2 Hypertension of 2-3 Degrees, with Moderate and High Cardiovascular Risk and Gender Characteristics of the Revealed Disorders

Lviv clinical bulletin ◽

10.25040/lkv2021.01-02.014 ◽

2021 ◽

Vol 1-2 (33-34) ◽

pp. 14-18

Author(s):

V. Skybchyk ◽

◽

O. Pylypiv ◽

Keyword(s):

Blood Pressure ◽

Cognitive Impairment ◽

Cardiovascular Risk ◽

Cognitive Functions ◽

Healthy Individuals ◽

High Cardiovascular Risk ◽

Hypertensive Patients ◽

Female Patients ◽

Male Patients ◽

Stage 1

Context. It is known that in addition to transient ischemic attacks and insults, hypertension is often the cause of asymptomatic brain damage, including cognitive impairment (CI). Most of these studies show a positive relationship between midlife hypertension and cognitive decline at the advanced age. CI significantly affect the quality of life of patients, reduce the ability to learn, acquire new knowledge and skills, force them to change their usual way of life and often stop or reduce professional activities. Objective. To analyze the condition of cognitive functions in patients with stage 1 and stage 2 hypertension of 2nd-3rd degrees, with moderate and high cardiovascular risk and evaluate their gender peculiarities. Materials and methods. The study included 90 patients with stage 1 and stage 2 hypertension. The average age of patients with hypertension was 49.66 ± 8.74 years old. The average course of the disease was 7.7 ± 3.9 years. The comparison group consisted of 46 healthy individuals with normal blood pressure levels and without hypertension in anamnesis (the average age - 45.88 ± 3.03 years old). Applied methods included general clinical, methods of neuropsychological testing (MMSE, GPCOG, W. Schulte test), standard general clinical and biochemical laboratory methods (blood lipid spectrum, blood glucose, creatinine with GFR, electrolytes), instrumental (12-lead ECG, ambulatory monitoring of blood pressure, echocardiography in B-, D-modes), and statistical methods. Results. Patients with hypertension scored significantly less on the MMSE scale (26.82 ± 1.41 scores vs. 28.89 ± 0.82 scores, p = 0.001) and GPCOG (6.63 ± 1.88 scores vs. 8.35 ± 0.71 scores, p = 0.001) compared with healthy individuals and spent more time on performing Walter Schulte test (46.51 ± 8.59 seconds vs. 36.69 ± 6.77 seconds, p = 0.001). Moderate CI were detected in 36 patients (40.00 %) among the examined hypertensive patients; it means that the total score of MMSE was 24-26 scores (the norm is 27-30 scores). The total score on the MMSE scale was 25.47 ± 0.88 in hypertensive patients with CI and was significantly lower than in hypertensive patients without CI (р = 0.001). Cognitive functions in patients with CI were characterized by poorer indices of memory, counting and executive functions. It should be noted that the revealed changes had more reliable manifestations in male hypertensive patients. In particular, the total score on the MMSE scale was 26.57 ± 1.37, while in female ones it was 27.19 ± 1.41 scores (p = 0.04). CI on the MMSE scale were diagnosed in 43.4 % (n = 23) of male patients and in 35.1 % (n = 13) of female patients. The total score was also higher on the GPCOG scale in female patients - 6.89 ± 1.85 scores vs. 6.45 ± 1.89 scores, p = 0.26. Instead, the time to complete the tasks according to the Walter Schulte tables was longer in male patients - 47.74 ± 8.85 seconds vs. 47.73 ± 7.99 seconds, p = 0.10, respectively. The parameters of counting functions were significantly lower (p = 0.01) in the group of male hypertensive patients compared with female ones. Besides, men had lower indicators of short-term memory and orientation, women reproduced worse verbal material, but the difference was statistically insignificant (p-value more than 0.05). The sum of scores on the MMSE scale conversely correlated with male gender (r = -0.22, p = 0.03). The risk of low values of MMSE indices in male patients with hypertension was 42.00 % higher than in female ones (OR = 1.42 ± 0.32, with 95% CІ [0.18-2.65]). Conclusions. Hypertension is a significant independent risk factor for developing new cases of cognitive impairment. In particular, among the patients with stage 1 and stage 2 hypertension of 2nd-3rd degrees, with moderate and high cardiovascular risk, moderate cognitive impairment was revealed in 36 patients (40,00 %), the revealed changes were more manifested in male hypertensive patients.

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