Objective To explore the value of blood pressure variability (BPV) combined with serum homocysteine (Hcy) detection in the assessment of cognitive function in elderly frail patients with hypertension.

Methods A total of 106 elderly frail patients with hypertension (aged ≥ 65 years) were selected. According to the exclusion criteria, the cognitive function of all patients was evaluated using the mini mental state examination (MMSE), and the patients were divided intro the cognitive dysfunction group and normal cognitive function group according to their cognitive function levels (53 casesin each group). The general information, medical history data and laboratory test results of the patients were collected, the correlation between general information and other indicators and MMSE scores were analyzed, the influencing factors of cognitive function evaluation results were explored, and the ROC curve was used to evaluate the predictive value of Hcy, BPV and their combined prediction models for cognitive function.

Results The results of Spearman correlation analysis showed that the Hcy, 24-hour systolic blood pressure coefficient of variation, 24-hour diastolic blood pressure coefficient of variation, age, urea, creatinine were negatively correlated with MMSE score. The results of multivariate logistic regression analysis showed that the Hcy, 24-hour systolic blood pressure coefficient of variation, 24-hour diastolic blood pressure coefficient of variation and age were all independent risk factors for cognitive impairment in the elderly. ROC curve analysis showed that the area under the curve (AUC) of the combined detection of Hcy and BPV for predicting cognitive dysfunction in elderly patients with frail hypertension was 0.889, which was superior to that of individual detection.

Conclusions The Hcy, BPV and their combined detection can be regarded as the predictive factors for cognitive dysfunction in elderly patients with frailty and hypertension, and the combination prediction of the two for the cognitive function level of elderly frail hypertensive patients is better than a single indicator.