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The Relationship between the Most Common Subtypes of Dementia and Orthostatic Hypotension in Older Adults

Authors
  • Isik, Ahmet Turan
  • Kocyigit, Suleyman Emre
  • Kaya, Derya
  • Dost Gunay, Fatma Sena
  • Erken, Neziha
  • Dokuzlar, Ozge
  • Aydin, Ali Ekrem
  • Ates Bulut, Esra
Type
Published Article
Journal
Dementia and Geriatric Cognitive Disorders
Publisher
S. Karger AG
Publication Date
Mar 18, 2021
Volume
49
Issue
6
Pages
628–635
Identifiers
DOI: 10.1159/000513978
PMID: 33735870
Source
Karger
Keywords
License
Green
External links

Abstract

Background: It is crucial to evaluate the causes of morbidity and mortality in elderly patients with dementia, such as orthostatic hypotension (OH), which may affect their daily life activities, reduce the quality of life, and increase the caregiver burden. Objective: We aimed to investigate the relationship between OH and the most common subtypes of dementia in detail. Methods: A total of 268 older adults with dementia diagnosed with Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), vascular dementia (VaD), and behavioral variant frontotemporal dementia (bvFTD), and 539 older adults without dementia were included in this prospective study. Comprehensive geriatric assessment including comorbidity, medication evaluation, and the head-up tilt test was also performed. Results: Of the participants, 13.8, 8.3, 6.4, and 4.8% had AD, DLB, bvFTD, and VaD, respectively. After adjusting for age, gender, the presence of comorbidities, and usage of OH-induced drugs; AD, DLB, and VaD were associated with OH (odds ratio [OR]: 2.23 confidence interval [CI] 95% 1.31–3.80; p = 0.003; OR: 3.68 CI 95% 1.98–6.83; p < 0.001, and OR: 3.56 CI 95% 1.46–8.69; p = 0.005, respectively). Furthermore, VaD was independently related to diastolic OH (OR: 4.19 CI 95% 1.66–10.57; p = 0.002), whereas AD and DLB were not. Conclusions: This study shows that elderly patients with DLB, AD, and VaD often have OH, a disabling autonomic dysfunction feature. Moreover, diastolic OH may play a role in the development of VaD. Therefore, considering potential complications of OH, it is essential to evaluate OH in the follow-up and management of those patients.

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