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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

Observed survival for the OH+ group (grey) and for the OH-group (black).
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Figure 2: Observed survival for the OH+ group (grey) and for the OH-group (black).

Mentions: As of October 1, 2012, a total of 14 patients out of 29 (48%) had died in the OH+ group, whereas 29 out of 57 (51%) had died in the OH-group. A Kaplan-Meier plot with separate survival curves for each OH group is shown in figure 2. As can be seen, the curves are very similar. The mean survival time in the OH-group was 5.7 years (95% CI: 5.2-6.3), and in the OH+ group 5.8 years (95% CI: 5.1-6.5); the corresponding median survival times were 6.8 and 6.2 years. A Cox regression model showed no significant effect of OH status (unadjusted p = 0.999). Adjusted for age and sex (both contributing significantly to the model), the estimated HR for OH+ versus OH-was 0.83 (95% CI: 0.44-1.57, p = 0.562). Adding other baseline variables to the model (smoking, CDR-SB score, MMSE score, CIRS score, cardiovascular disease, AD vs. non-AD dementia, or centre) did not change the results substantially; neither did OH status interact statistically significantly with time in the tested models.


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)

Observed survival for the OH+ group (grey) and for the OH-group (black).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Observed survival for the OH+ group (grey) and for the OH-group (black).
Mentions: As of October 1, 2012, a total of 14 patients out of 29 (48%) had died in the OH+ group, whereas 29 out of 57 (51%) had died in the OH-group. A Kaplan-Meier plot with separate survival curves for each OH group is shown in figure 2. As can be seen, the curves are very similar. The mean survival time in the OH-group was 5.7 years (95% CI: 5.2-6.3), and in the OH+ group 5.8 years (95% CI: 5.1-6.5); the corresponding median survival times were 6.8 and 6.2 years. A Cox regression model showed no significant effect of OH status (unadjusted p = 0.999). Adjusted for age and sex (both contributing significantly to the model), the estimated HR for OH+ versus OH-was 0.83 (95% CI: 0.44-1.57, p = 0.562). Adding other baseline variables to the model (smoking, CDR-SB score, MMSE score, CIRS score, cardiovascular disease, AD vs. non-AD dementia, or centre) did not change the results substantially; neither did OH status interact statistically significantly with time in the tested models.

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