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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

Course of MMSE scores for 86 patients having either persistent OH (OH+) or never OH (OH-) at baseline and the 1-year follow-up. Observed individual curves (light grey) as well as fitted LOESS curves for the mean responses for the OH-group (solid black line) and for the OH+ group (dashed black line).
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Figure 5: Course of MMSE scores for 86 patients having either persistent OH (OH+) or never OH (OH-) at baseline and the 1-year follow-up. Observed individual curves (light grey) as well as fitted LOESS curves for the mean responses for the OH-group (solid black line) and for the OH+ group (dashed black line).

Mentions: In total, we had 349 observations of MMSE scores and 350 observations of CDR-SB scores for the 86 patients who were classified as either OH+ or OH-. So-called spaghetti plots of these observations, with LOESS curves fitted to each group separately, are shown in figures 5 and 6, respectively. These plots seem to imply that OH status has little impact on the course of CDR-SB and MMSE scores, as the LOESS curves are very similar for the OH- and the OH+ groups. The differences are found mostly towards the end, where the data are increasingly scarce. Using GEE modelling (table 3), we found that there was indeed no evidence of a differential longitudinal development in CDR-SB scores according to OH status (p > 0.76 for the interaction effect in all models); furthermore, there was no evidence of a difference in scores at baseline (p > 0.42). With regard to MMSE scores (table 4), some differences at baseline showed up in the adjusted estimates (models 3 and 4, p < 0.005); however, we found little evidence of a difference in the slopes of the curves (all p ≥ 0.24).


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)

Course of MMSE scores for 86 patients having either persistent OH (OH+) or never OH (OH-) at baseline and the 1-year follow-up. Observed individual curves (light grey) as well as fitted LOESS curves for the mean responses for the OH-group (solid black line) and for the OH+ group (dashed black line).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Course of MMSE scores for 86 patients having either persistent OH (OH+) or never OH (OH-) at baseline and the 1-year follow-up. Observed individual curves (light grey) as well as fitted LOESS curves for the mean responses for the OH-group (solid black line) and for the OH+ group (dashed black line).
Mentions: In total, we had 349 observations of MMSE scores and 350 observations of CDR-SB scores for the 86 patients who were classified as either OH+ or OH-. So-called spaghetti plots of these observations, with LOESS curves fitted to each group separately, are shown in figures 5 and 6, respectively. These plots seem to imply that OH status has little impact on the course of CDR-SB and MMSE scores, as the LOESS curves are very similar for the OH- and the OH+ groups. The differences are found mostly towards the end, where the data are increasingly scarce. Using GEE modelling (table 3), we found that there was indeed no evidence of a differential longitudinal development in CDR-SB scores according to OH status (p > 0.76 for the interaction effect in all models); furthermore, there was no evidence of a difference in scores at baseline (p > 0.42). With regard to MMSE scores (table 4), some differences at baseline showed up in the adjusted estimates (models 3 and 4, p < 0.005); however, we found little evidence of a difference in the slopes of the curves (all p ≥ 0.24).

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