REVIEW article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1659043
The relationship between Orthostatic hypotension and Cognitive impairment in Parkinson's disease : A Systematic Review and Meta-analysis
Provisionally accepted
- School of Medicine, Tongji University, Shanghai, China
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OH and cognitive impairment are prevalent non-motor symptoms in PD. Although numerous epidemiological studies have explored the association between OH and cognitive impairment, the findings remain controversial. This study aims to systematically evaluate the relationship between OH and cognitive function in patients with PD and to investigate the impact of OH on different cognitive domains. Methods Databases including CNKI , Wanfang Database, SinoMed, VIP , PubMed, Embase, Cochrane Library, Web of Science, ProQuest, Scopus, and Ovid were searched for eligible publications from their inception to July 2025. After literature screening and quality evaluation based on inclusion and exclusion criteria, meta-analysis, heterogeneity testing, sensitivity analysis, and subgroup analysis were conducted using Review Manager 5.4 software. Results Thirteen studies with a total of 1417 participants were ultimately included, consisting of 552 Parkinson's patients with OH (PD-OH group) and 865 Parkinson's patients without OH (PD-NOH group). Compared to the PD-NOH group, the global cognitive score of the PD-OH group was significantly lower [SMD = - 0.62, 95%CI [-0.78, - 0.46], P < 0.01]. In terms of cognitive domains, the PD-OH group presented the following results: Memory [SMD = - 0.12, 95% CI (-0.64, 0.17), P = 0.25], Executive function [SMD = - 0.29, 95% CI (-0.50, - 0.07), P < 0.01], Verbal [SMD = - 0.35, 95% CI (-0.65, - 0.04), P < 0.01], Attention [SMD = - 0.12, 95% CI (-0.33, 0.09), P = 0.27], and Visuospatial function [SMD = - 0.40, 95% CI (-0.61, - 0.18), P < 0.01]. PD patients with OH did not exhibit significant cognitive impairment in the attention and memory domains, but showed marked cognitive deficits in the executive function, verbal, and visuospatial function domains. Conclusion This meta-analysis indicates that cognitive function decline in PD patients is associated with OH. Patients with OH have lower global cognitive scores compared to those without OH, particularly demonstrating significant deficits in executive function, verbal, and visuospatial function, especially in those with long disease duration. Clinicians should be vigilant about these potential cognitive deficits and consider comprehensive cognitive assessments and targeted interventions for PD patients experiencing OH.
Keywords: Parkinson's disease, orthostatic hypotension, cognitive impairment, Meta-analysis, PD dementia
Received: 03 Jul 2025; Accepted: 19 Aug 2025.
Copyright: © 2025 Liu, Jiang, Wang and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Shi, School of Medicine, Tongji University, Shanghai, China
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