AGEING, ORTHOSTATIC HYPOTENSION, AND MENTAL HEALTH: A CROSS-SECTIONAL STUDY IN NDOLA CITY OF ZAMBIA

Kartheek R. Balapala, Victor Mwanakasale

Abstract


Background: This study examines the relationship between ageing, standing blood pressure, and mental health in 770 adults from Ndola City, Zambia, focusing on orthostatic hypotension (OH). OH, characterized by a significant drop in blood pressure upon standing, is particularly prevalent among older adults and is associated with mental health disorders such as depression and stress. Methods: Using a cross-sectional design, participants were categorized by age, and standard blood pressure measurements were taken to assess OH. Mental health was evaluated using the Depression, Anxiety, and Stress Scale (DASS21) and the General Health Questionnaire (GHQ12). Statistical analyses, including Pearson chi-square tests, were employed to explore associations between age groups, the prevalence of OH, and mental health conditions. Results: Results indicated no significant association between age and the occurrence of OH (Pearson chi2(4) = 7.5702, Pr = 0.109). However, a significant relationship was found between age and depression (Pearson chi2(8) = 23.4265, Pr = 0.003), suggesting that older age correlates with higher depression levels. In contrast, anxiety did not show a significant association with age (Pearson chi2(4) = 4.5814, Pr = 0.333). Stress levels were significantly associated with age (Pearson chi2(8) = 37.1247, Pr = 0.000), as were distress levels (Pearson chi2(4) = 9.9089, Pr = 0.042). Conclusion: While age does not significantly impact the occurrence of OH, it is correlated with increased levels of depression and stress among older adults, highlighting the need for mental health interventions in this population.

 

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Keywords


ageing, orthostatic hypotension (OH), blood pressure, mental health, Africa

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References


American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Retrieved from https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596

Antony M M, Bieling P J, Cox B J, Enns M W, Swinson R P, 1998. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment 10(2):176–181. Retrieved from https://psycnet.apa.org/record/1998-02891-012

Benrud-Larson L, Barlow A, Hodge D, 2012. Orthostatic hypotension and psychiatric comorbidities in patients with dizziness. PubMed. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22115864/

Borsa J C, Damásio B F, Bandeira D R, 2012. Adaptação e validação de instrumentos psicológicos entre culturas: algumas considerações. Paidéia (Ribeirão Preto) 22(53):423–432. Retrieved from https://www.scielo.br/j/paideia/a/cbRxjMqmbZddKpwywVM8mJv/?lang=pt

Creswell J W, Creswell J D, 2017. Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications. Retrieved from https://www.ucg.ac.me/skladiste/blog_609332/objava_105202/fajlovi/Creswell.pdf

Czajkowska J, Kuczynska K, Kaczmarek K, 2010. Cognition and hopelessness in association with subsyndromal orthostatic hypotension. The Journals of Gerontology: Series A 65A(8): 873-879. https://doi.org/10.1093/gerona/glq068

Dani M, Dirksen A, Taraborrelli P, Panagopolous D, Torocastro M, Sutton R, 2021. Orthostatic hypotension in older people: considerations diagnosis and management. Age and Ageing 50(3):647–654. Retrieved from https://doi.org/10.7861/clinmed.2020-1044

Daza P, Novy D M, Stanley M A, Averill P, 2002. The Depression Anxiety Stress Scale-21: Spanish translation and validation with a Hispanic sample. Journal of Psychopathology and Behavioral Assessment 24(3): 195-205. https://psycnet.apa.org/record/2002-04019-007

Faul F, Erdfelder E, Buchner A, Lang A-G, 2009. Statistical power analyses using G*Power3. 1: Tests for correlation and regression analyses. Behavior Research Methods41(4):1149–1160. https://doi.org/10.3758/brm.41.4.1149

Gibbons R J, Balady G J, 2002. Exercise as a therapeutic intervention: An overview. The American Journal of Medicine 112(9): 1-7. doi: 10.1016/S0002-9343(02)01160-0

Goldberg D P, Williams P, 1988. A User's Guide to the General Health Questionnaire. Windsor, UK: NFER-Nelson. Retrieved from https://books.google.ro/books/about/A_User_s_Guide_to_the_General_Health_Que.html?id=LpSuGQAACAAJ&redir_esc=y

Hillebrand S L, Reijnierse E M, Meskers C G M, Maier A B, 2021. Orthostatic hypotension assessed by active standing is associated with worse cognition in geriatric rehabilitation inpatients. Journal of the American Medical Directors Association 22(7): 1360-1365. https://doi.org/10.1016/j.archger.2021.104482

Kamaruzzaman S B, Tan M P, Sulaiman A H, 2010. The relationship between depression and orthostatic hypotension in older people. Journal of the American Geriatrics Society 58(4):758–759.

Kanjwal K, Karabin B, Kanjwal Y, Grubb B P, 2015. Orthostatic hypotension due to autonomic disorders. Cardiology Clinics 33(3): 451-460. Retrieved from http://dx.doi.org/10.4137/CMC.S926

Low P A, 2008. Prevalence of orthostatic hypotension. Clinical Autonomic Research 18(1): 8-13. https://doi.org/10.1007/s10286-007-1001-3

Mancia, G., Kreutz, R., Brunström, M., Burnier, M., Grassi, G., Januszewicz, A., Muiesan, M. L., Tsioufis, K., Agabiti-Rosei, E., Algharably, E. A. E., Azizi, M., Benetos, A., Borghi, C., Hitij, J. B., Cifkova, R., Coca, A., Cornelissen, V., Cruickshank, J. K., Cunha, P. G., Danser, A. H. J., … Kjeldsen, S. E. (2023). 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). Journal of hypertension, 41(12), 1874–2071. https://doi.org/10.1097/HJH.0000000000003480

McGowan S, Mullen D, McCormack P, 2021. Orthostatic hypotension: Management of a complex, but common disorder. Circulation: Arrhythmia and Electrophysiology. Retrieved from https://www.ahajournals.org/doi/10.1161/CIRCEP.121.010573

Picone, D. S., Schultz, M. G., Otahal, P., Aakhus, S., Al-Jumaily, A. M., Black, J. A., Bos, W. J., Chambers, J. B., Chen, C. H., Cheng, H. M., Cremer, A., Davies, J. E., Dwyer, N., Gould, B. A., Hughes, A. D., Lacy, P. S., Laugesen, E., Liang, F., Melamed, R., Muecke, S., … Sharman, J. E. (2017). Accuracy of Cuff-Measured Blood Pressure: Systematic Reviews and Meta-Analyses. Journal of the American College of Cardiology, 70(5), 572–586. https://doi.org/10.1016/j.jacc.2017.05.064

Polit D F, Beck C T, 2021. Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Lippincott Williams & Wilkins. Retrieved from https://cmc.marmot.org/Record/.b54061398

Roca F, Rougette K, Zmuda L, et al., 2022. Association between orthostatic blood pressure dysregulation and geriatric syndromes: A cross-sectional study. BMC Geriatrics 22: 157. doi: 10.1186/s12877-022-02844-8. Retrieved from https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-02844-8

Ruiz F J, García-Martín M B, Suárez-Falcón J C Odriozola-González P, 2017. The hierarchical factor structure of the Spanish version of Depression Anxiety and Stress Scale-21. International Journal of Psychology and Psychological Therapy17(1):97–105. Retrieved from https://www.researchgate.net/publication/313351122_The_hierarchical_factor_structure_of_the_Spanish_version_of_the_Depression_Anxiety_and_Stress_Scale_-_21_DASS-21

Saedon N I et al., 2020. Orthostatic hypotension assessed by active standing is associated with worse cognition in geriatric rehabilitation inpatients. Journal of the American Medical Directors Association 21(7):1008–1014.

Safarpour M, Fotouhi A, Hosseini S R, Mohamadzade M, Bijani A, 2019. Predictors of Orthostatic Hypotension in the Elderly: Results from the Amirkola Health and Ageing Project (AHAP) Study. Journal of Tehran University Heart Center 14(4):165–170. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7231680/

Shibao C, Arzubi S, Biaggioni I, 2013. Orthostatic hypotension in the elderly: A review. Clinical Autonomic Research 23(6): 337-346. doi: 10.1007/s10286-013-0222-2

Shibao C, Lipsitz L A, Biaggioni I, 2013. Evaluation and treatment of orthostatic hypotension. Journal of the American Society of Hypertension 7(4): 317-324. https://doi.org/10.1016/j.jash.2013.04.006

Ye S 2009. Factor structure of the General Health Questionnaire (GHQ-12): The role of wording effects. Personality and Individual Differences 46(2):197–201. https://doi.org/10.1016/j.paid.2008.09.027




DOI: http://dx.doi.org/10.46827/ejphs.v7i3.195

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