Hypertension and cognitive dysfunction among older persons in rural northern Uganda: a cross-sectional study

Abstract Background Hypertension is common among older adults and may impact their cognitive function. Available data on this association is mostly from resource rich settings and has been understudied in resource limited settings especially rural areas where majority of older persons live. We examined the association between hypertension and cognitive dysfunction in older persons in Kole, a rural district in Uganda and examined whether sex is an effect modifier. Methods We conducted a community-based cross-sectional study among older persons aged ≥ 60 years in rural northern Uganda sampled through a multi-stage process. The primary exposure was hypertension measured by systolic (≥ 140 mmHg) or diastolic blood pressure (≥ 90 mmHg), or being on anti-hypertensives. The outcome was cognitive dysfunction measured by the Montreal Cognitive Assessment, with scores < 26. Analysis used the modified Poisson regression with robust standard errors at a 5% significance level. Results We studied 420 participants and found 288 (68.6%) had hypertension while 213 (50.7%) had some cognitive dysfunction. Hypertension was associated with cognitive dysfunction (adjusted prevalence risk [aPR] 1.26, 95% CI 1.01–1.57), with factors such as 4–5 people in the household (aPR 0.80, 95% CI 0.64–0.99), no smoking history (aPR 0.57, 95% CI 0.43–0.76), and dissatisfaction with one’s health (aPR 1.68, 95% CI 1.27–2.21) and satisfaction with ability to perform usual domestic duties (aPR 0.74, 95% CI 0.55–0.99) being associated. In a sex stratified analysis, men with hypertension were more likely to experience cognitive dysfunction (aPR 2.13, 95% CI 1.33–3.40), while women with hypertension were less likely (aPR 0.97, 95% CI 0.96–1.24) when compared to their normotensive counterparts. Conclusion Hypertension is associated with cognitive dysfunction in older individuals. Sex modifies the effect of hypertension on cognitive function. Our results strengthen the importance of regular blood pressure measurement and control in older individuals.