The prevalence of hypertension and cognitive dysfunction in the elderly in China is not optimistic, and hypertension has been associated with an increased risk of developing cognitive dysfunction. It is of great significance to explore and promote the methods for prevention and control of cognitive dysfunction in elderly patients with hypertension in community.

To explore the effect of leisure physical activities on cognitive function in elderly patients with hypertension in community.

From August 2020 to December 2020, a total of 770 patients with hypertension aged ≥65 years who underwent chronic disease management were selected from community health service centers in Wuhan using the stratified random sampling method. A questionnaire was administered to obtain the general information of the subjects, leisure physical activity (including 6 cognitive activities and 11 physical activities) and cognitive function (using the Mini-Mental State Examination Scale). Multivariate Logistic regression was used to analyze the influencing factors of cognitive dysfunction in elderly patients with hypertension. Multiple linear regression was used to analyze the influence of leisure physical activity on cognitive function in elderly patients with hypertension. Multiple Logistic regression was used to analyze the influence of the weekly participation frequency of 17 leisure physical activity on cognitive dysfunction in elderly patients with hypertension.

The incidence of cognitive dysfunction in elderly hypertensive patients in community was 39.4% (303/770). There were significant differences in gender, age, education, duration of hypertension, leisure physical activity scores between patients with and without cognitive impairment (P<0.05). Multivariate Logistic regression analysis showed that duration of hypertension〔OR (95%CI) =1.02 (1.01, 1.03) 〕 and leisure physical activity score〔OR (95%CI) =0.98 (0.96, 0.99) 〕 were influencing factors for the development of cognitive impairment in older patients with hypertension. Further analysis found that the leisure physical activity score was an influential factor in the MMSE for scores on the attention and calculation power dimension〔b (95%CI) =0.02 (0.01, 0.03) 〕, the language ability dimension score〔b (95%CI) =0.02 (0.01, 0.03) 〕. After refining the categories to leisure physical activity style, the results of multivariate Logistic regression analysis showed that older adults with hypertension who participated in writing〔OR (95%CI) =0.34 (0.12, 0.95) 〕, board games〔OR (95%CI) =0.21 (0.06, 0.72) 〕 daily were less likely to be cognitively impaired than those who occasionally/never participated in this activity.

Leisure physical activity is a protective factor of cognitive function in elderly patients with hypertension, which mainly affects two dimensions of cognitive function: attention and calculating ability, and language ability. Daily participation in writing and checkerboard games play a positive role in cognitive function in elderly patients with hypertension.

我国老年人的高血压和认知功能障碍患病形势不容乐观，且高血压会增加认知功能障碍的发生风险，因此探讨防治老年高血压患者认知功能障碍的方法并在社区进行推广具有十分重要的意义。

探讨休闲身体活动对社区老年高血压患者认知功能的影响。

于2020年8—12月，采取多阶段随机抽样法，抽取在武汉市社区卫生服务中心接受慢性病管理的≥65岁高血压患者770例。采用问卷调查，获取受试者的一般资料、休闲身体活动情况（包括6项认知活动和11项体育活动）、认知功能情况〔采用简易精神状态评价量表（MMSE）测量〕。采用多因素Logistic回归分析老年高血压患者发生认知功能障碍的影响因素，采用多元线性回归分析老年高血压患者休闲身体活动得分对MMSE各维度得分的影响，采用多因素Logistic回归分析17项休闲身体活动每周参与频率对老年高血压患者发生认知功能障碍的影响。

社区老年高血压患者的认知功能障碍检出率为39.4%（303/770）。是否发生认知功能障碍患者的性别、年龄、受教育程度、高血压病程、休闲身体活动得分比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，高血压病程〔OR（95%CI）=1.02（1.01，1.03）〕、休闲身体活动得分〔OR（95%CI）=0.98（0.96，0.99）〕是老年高血压患者发生认知功能障碍的影响因素；进一步分析发现，休闲身体活动得分是MMSE中注意力与计算力维度得分〔b（95%CI）=0.02（0.01，0.03）〕、语言能力维度得分〔b（95%CI）=0.02（0.01，0.03）〕的影响因素。将休闲身体活动方式细化分类后，多因素Logistic回归分析结果显示，每日参与写作〔OR（95%CI）=0.34（0.12，0.95）〕、每日参与棋牌游戏〔OR（95%CI）=0.21（0.06，0.72）〕的老年高血压患者认知功能障碍发生率低于偶尔/从不参与该项活动者。

休闲身体活动是老年高血压患者认知功能的保护性因素，主要影响认知功能的注意力与计算力、语言能力两个维度。每日参与写作、每日参与棋牌游戏对老年高血压患者的认知功能起积极作用。