Limits...
Persistence and Prognostic Implications of Orthostatic Hypotension in Older Individuals with Mild-to-Moderate Dementia.

Soennesyn H, Dalen I, Aarsland D - Dement Geriatr Cogn Dis Extra (2014)

Bottom Line: Patients with OH at both baseline and the 1-year follow-up were classified as having persistent OH.From baseline to the 4-year follow-up, 30-45% of the participants had OH at each follow-up.OH was moderately prevalent over 4 years in older individuals with mild dementia, and persistent OH did not predict either cognitive or functional decline or survival.

View Article: PubMed Central - PubMed

Affiliation: Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.

ABSTRACT

Aim: To study the course and prognostic implications of orthostatic hypotension (OH) in older individuals with mild-to-moderate dementia.

Methods: Referrals to outpatient clinics specialising in old age psychiatry and geriatric medicine in the counties of Rogaland and Hordaland in western Norway with a first-time diagnosis of mild dementia were consecutively asked for inclusion. A total of 211 participants underwent a comprehensive baseline assessment with annual follow-ups. Patients with OH at both baseline and the 1-year follow-up were classified as having persistent OH. Outcome measures were the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating sum of boxes (CDR-SB), and time to death.

Results: From baseline to the 4-year follow-up, 30-45% of the participants had OH at each follow-up. In multivariable analysis, persistent OH was not significantly associated with either the longitudinal course of MMSE or CDR-SB scores or survival.

Conclusions: OH was moderately prevalent over 4 years in older individuals with mild dementia, and persistent OH did not predict either cognitive or functional decline or survival.

No MeSH data available.


Related in: MedlinePlus

OH classification flow chart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4325905&req=5

Figure 1: OH classification flow chart.

Mentions: Of the 133 patients who had complete data on OH measurements at both baseline and the 1-year follow-up, 29 were OH positive on both occasions and were thus classified as ‘persistent OH’ (OH+), whereas 57 were OH negative on both occasions and were classified as ‘never OH’ (OH-; fig. 1). There were no significant differences in mean non-standing systolic or diastolic blood pressure between those measured in the supine and those measured in the sitting position at baseline (data not shown). The general condition of the patients in these groups (OH+ and OH-) at baseline did not differ significantly [good general condition (compared with average or bad): 93 vs. 85%, p = 0.482], and the median CIRS total score was 6.0 (potential maximum score: 52) in both groups (p = 0.491). There were no significant differences between the OH+ and the OH-group with respect to history of hypertension (55 vs. 44%, p = 0.437), prevalence of diabetes mellitus type 1 or 2 (13 vs. 0%, p = 0.090), prevalence of kidney disease (median CIRS renal score 0 in both groups), use of at least 1 medication associated with OH (antianginals, antihypertensives, tricyclic antidepressants, paroxetine, MAO inhibitors, dopamine agonists, diazepam, dipyridamole, phenothiazines, clozapine, quetiapine, olanzapine, or haloperidol; 59 vs. 54%, p = 0.831), use of antihypertensive medication (55 vs. 46%, p = 0.592), or Scheltens total WMH score (median score: 11.5 vs. 14.0, p = 0.525). Baseline serum lipid values were available for only 3 of these patients.


Persistence and Prognostic Implications of Orthostatic Hypotension in Older Individuals with Mild-to-Moderate Dementia.

Soennesyn H, Dalen I, Aarsland D - Dement Geriatr Cogn Dis Extra (2014)

OH classification flow chart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325905&req=5

Figure 1: OH classification flow chart.
Mentions: Of the 133 patients who had complete data on OH measurements at both baseline and the 1-year follow-up, 29 were OH positive on both occasions and were thus classified as ‘persistent OH’ (OH+), whereas 57 were OH negative on both occasions and were classified as ‘never OH’ (OH-; fig. 1). There were no significant differences in mean non-standing systolic or diastolic blood pressure between those measured in the supine and those measured in the sitting position at baseline (data not shown). The general condition of the patients in these groups (OH+ and OH-) at baseline did not differ significantly [good general condition (compared with average or bad): 93 vs. 85%, p = 0.482], and the median CIRS total score was 6.0 (potential maximum score: 52) in both groups (p = 0.491). There were no significant differences between the OH+ and the OH-group with respect to history of hypertension (55 vs. 44%, p = 0.437), prevalence of diabetes mellitus type 1 or 2 (13 vs. 0%, p = 0.090), prevalence of kidney disease (median CIRS renal score 0 in both groups), use of at least 1 medication associated with OH (antianginals, antihypertensives, tricyclic antidepressants, paroxetine, MAO inhibitors, dopamine agonists, diazepam, dipyridamole, phenothiazines, clozapine, quetiapine, olanzapine, or haloperidol; 59 vs. 54%, p = 0.831), use of antihypertensive medication (55 vs. 46%, p = 0.592), or Scheltens total WMH score (median score: 11.5 vs. 14.0, p = 0.525). Baseline serum lipid values were available for only 3 of these patients.

Bottom Line: Patients with OH at both baseline and the 1-year follow-up were classified as having persistent OH.From baseline to the 4-year follow-up, 30-45% of the participants had OH at each follow-up.OH was moderately prevalent over 4 years in older individuals with mild dementia, and persistent OH did not predict either cognitive or functional decline or survival.

View Article: PubMed Central - PubMed

Affiliation: Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.

ABSTRACT

Aim: To study the course and prognostic implications of orthostatic hypotension (OH) in older individuals with mild-to-moderate dementia.

Methods: Referrals to outpatient clinics specialising in old age psychiatry and geriatric medicine in the counties of Rogaland and Hordaland in western Norway with a first-time diagnosis of mild dementia were consecutively asked for inclusion. A total of 211 participants underwent a comprehensive baseline assessment with annual follow-ups. Patients with OH at both baseline and the 1-year follow-up were classified as having persistent OH. Outcome measures were the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating sum of boxes (CDR-SB), and time to death.

Results: From baseline to the 4-year follow-up, 30-45% of the participants had OH at each follow-up. In multivariable analysis, persistent OH was not significantly associated with either the longitudinal course of MMSE or CDR-SB scores or survival.

Conclusions: OH was moderately prevalent over 4 years in older individuals with mild dementia, and persistent OH did not predict either cognitive or functional decline or survival.

No MeSH data available.


Related in: MedlinePlus