Determinants of Cognitive Performance Among Ghanaian Hypertensive Patients: A Cross-Sectional Study

Abstract

Background: Cognitive decline is one of the most deleterious consequences of hypertension. Hypertension is rife in sub-Saharan Africa, where control of blood pressure is abysmally poor.

Objective: This study is aimed at assessing the determinants of cognitive performance among Ghanaian hypertensive patients.

Methods: This was a cross-sectional study conducted at a single district hospital among hypertensives aged ≥ 18 years. Global cognitive performance is assessed using the Montreal Cognitive Assessment (MOCA). A multivariable linear regression analysis was performed, and a beta coefficient was computed to identify factors independently associated with the MOCA score.

Results: We enrolled 214 adults living with hypertension; the mean (SD) age was 64 (13.4) years, and 168 (78.5%) were females. Factors, with their adjusted beta coefficients (95% CI), independently associated with cognitive performance were age, -0.10 (-0.16, -0.04), p < 0.001; female sex, -2.3 (-4.2, -0.35), p = 0.021, secondary and tertiary-level educational attainment +5.2 (3.5, 6.9), p < 0.001 and +4.1 (0.49, 7.7), p = 0.026 respectively. In sensitivity unadjusted analyses, body mass index (BMI), with a beta coefficient of +0.18(0.08, 0.29), p < 0.001, was associated with MOCA score in females. Among the male participants, a history of heart failure, -11 (-15, -5.9), p < 0.001, history of stroke -11 (-15, -5.9), p < 0.001, BMI -0.31 (-0.49, -0.13), p = 0.002 and uncontrolled hypertension -3.5 (-6.9, -0.15), p = 0.047 were associated with MOCA score.

Conclusion: Increasing age and female sex are associated with poorer global cognitive performance, while higher educational attainment is associated with good global cognitive performance among Ghanaians living with hypertension.

Keywords: Ghanaian; cognitive performance; determinant; hypertension.