Orthostatic Hypotension, Frailty, and Cognitive Impairments Among Older Adults: A Hospital-based Study

Background: Orthostatic hypotension (OH) is a common condition, affecting roughly 20% of community-dwelling older adults and up to 25% of those in long-term care facilities. Its presence in older adults has been linked to heightened risks of frailty, cognitive decline, and increased fall rates, yet few studies have comprehensively examined these associations in outpatient settings. This study investigates the relationships between OH, frailty, and cognitive impairments in older adults attending an outpatient geriatric clinic. Materials and Methods: A cross-sectional study was conducted among 250 older adults (aged 60 years and above) visiting the Outpatient Geriatric Clinic at Firoozabadi Hospital. Cognitive function was evaluated using the Abbreviated Mental Test Score (AMTS) and Mini-Cog, while frailty status was determined through the Fried Frailty Index. Results: Participants had an average age of 70.72 ± 7.24 years, with ages ranging from 60 to 90. Of the total participants, 38.8% (97) were male, and 61.2% (153) were female. Average systolic blood pressure (SBP) was 132.04 ± 21.64 mmHg, and average diastolic blood pressure (DBP) was 79.43 ± 13.01 mmHg. Among participants, 38% (95) reported a history of falls, and 34% (85) were on multiple medications (polypharmacy). Notably, 33.6% (84) were diagnosed with frailty syndrome, and 29.2% (73) exhibited prefrailty. Additionally, 34.4% (86) of the participants were found to have cognitive impairments. Conclusion: The study highlights significant associations between orthostatic hypotension, frailty, and cognitive impairment among older adults. participants displaying frailty, prefrailty, and cognitive impairments, these findings underscore the need for early screening and management of orthostatic hypotension in outpatient settings. Addressing OH could play a crucial role in mitigating frailty progression, preserving cognitive function, and reducing fall risk in older adults. Future research is warranted to explore intervention strategies that may improve the quality of life and functional outcomes in this vulnerable population.