Impact of ageing on orthostatic hypotension and mental health disorders: a cross-sectional study

Introduction. Orthostatic hypotension (OH) is a common cardiovascular issue in older adults, impacting both their overall well-being and mental health. This study investigates the association between aging, OH, and mental health disorders such as depression, anxiety, stress, and distress. It also examines potential confounding factors and the impact of OH on well-being. Materials and methods. A cross-sectional study was conducted among 770 adults (aged 16–60 years) in Ndola City, Zambia. OH was assessed by measuring blood pressure after five minutes of rest and at one and three minutes after standing. Mental health disorders were evaluated using the Depression, Anxiety, and Stress Scale (DASS-21) and the General Health Questionnaire (GHQ-12). Chi-square tests were used to explore associations between age, OH, and mental health outcomes, while logistic regression assessed the influence of demographic factors, chronic disease medications, and socioeconomic status. Structural equation modeling (SEM) was performed using STATA 16 and SPSS 26. Results. No significant association was found between age and OH (χ²(4)=7.57, p=0.109). However, age was significantly associated with depression (χ²(8)=23.43, p=0.003), stress (χ²(8)=37.12, p < 0.001), and distress (χ²(4)=9.91, p=0.042), but not anxiety (χ²(4)=4.55, p=0.353). SEM analysis indicated that depression significantly influenced OH, while employment and BMI did not. Medications partially mediated the relationship between depression and OH. The model explained 54.96% of the variance in OH. Conclusion. Age was not directly associated with OH but significantly influenced mental health conditions. Depression emerged as a key factor affecting OH, with medications playing a mediating role. These findings emphasize the need for comprehensive health strategies that address both cardiovascular and mental health concerns.