Is cognitive status of the Cretan elderly aged ≥ 75 years associated with known behavioral and vascular risk factors?

  • Ioanna StefanakiEmail author
  • Manolis Linardakis
  • Christos Lionis
Original Article



This study aimed to examine the association of blood hypertension and certain behavioral risk factors with cognitive decline in elderly individuals.


A subsample of 92 elderly people aged ≥ 75 years was taken from 411 people (aged 65+ years) living in a rural area of Crete, Greece. Detailed medical and family/social history data were recorded on a standard validated health card, and cognitive disorders were assessed using the Mini Mental State Examination (MMSE). The participants were evaluated for behavioral risk factors such as physical inactivity, smoking, alcohol consumption and dietary habits. Multiple logistic regression analysis was conducted to assess the risk (odds ratios, OR) of cognitive impairment.


The mean age of participants was 80.8 ± 4.3 years old with 66.3% being married, and their MMSE mean score was 23.4 ± 4.6; 46.7% had severe and/or mild symptoms of cognitive decline, while more than half (67.4%) had been diagnosed with hypertension. Living alone (OR: 3.48, p = 0.034), being physically inactive (OR: 5.65, p = 0.046) and low consumption of fruits and vegetables (OR: 4.16, p = 0.018) were found to increase the odds of cognitive impairment, while elderly people with hypertension were also found to have lower odds of cognitive impairment (OR: 0.42, p > 0.05).


Although the observational character of this study carries some potential limitations, the reverse association of cognitive capacity with hypertension constitutes a ‘paradox’ phenomenon and is in contrast to the current literature. Further research with a larger sample is needed to better understand the observed association.


Elderly Cognitive status Cardiovascular disease Hypertension Risk factor Primary care 



Mini Mental State Examination


Compliance with ethical standards

Research Involving Human Participants

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the University Hospital of Heraklion, Crete, Greece (no. 82, 3/20.07.2005) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Rural Surgery of EmbarosHealth Centre of ViannosHeraklionGreece
  2. 2.Clinic of Social and Family Medicine, School of MedicineUniversity of CreteHeraklionGreece

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