Observational studies have conveyed the connection between hypertension and cognitive impairment. Several forms of dementia are more frequent in hypertensive subjects or those with previous history of hypertension compared to subjects with normal blood pressure.
In many studies, hypertension occuring in mid-life is a risk factor of dementia occuring in later age. Long-standing hypertension will induce structural damages in the brain. It is also widely known that hypertension attributes to small vessel diseases causing lacunar infarcts and white matter lesions associated with cognitive decline. Due to availability and for cost efficiencies, widespread use of MRI in the evaluation of elderly with hypertension is limited. Nevertheless, silent brain infarctions should be sought in all hypertensives patients with neurological deficits and memory loss in particular. As cognitive disturbances are hypertension-related in some parts, suitable cognitive evaluation tests should be warranted in the clinical assessment of all hypertensive patients with cognitive complaints and in all elderly with hypertension. Hypertension is related with impairments in several cognitive domains like attention, language, short & long term memory, visuo-spatial and executive functions.