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Lack of orthostatic symptoms in dementia patients with orthostatic hypotension.

Bengtsson Lindberg, Marie LU ; Larsson, Victoria LU ; Minthon, Lennart LU ; Wattmo, Carina LU and Londos, Elisabet LU (2015) In Clinical Autonomic Research 25(2). p.87-94
Abstract
Purpose: Orthostatic hypotension (OH) is common and increases with age. OH is part of the autonomic dysfunction in dementia with Lewy bodies (DLB). Commonly OH is diagnosed when the patient falls which is a risk factor of premature death. Our objective was to systematically investigate the clinical symptoms associated with measurement of OH in different neurodegenerative dementias and normal controls (NC).

Methods: 154 patients [50 DLB, 50 Alzheimer’s disease (AD), 54 AD and vascular components (ADvasc)] were examined with systolic and diastolic blood pressure measurements in supine position, immediately after standing up and after 1, 3, 5 and 10 min of standing. They were compared with 50 NC. Orthostatic symptoms were registered... (More)
Purpose: Orthostatic hypotension (OH) is common and increases with age. OH is part of the autonomic dysfunction in dementia with Lewy bodies (DLB). Commonly OH is diagnosed when the patient falls which is a risk factor of premature death. Our objective was to systematically investigate the clinical symptoms associated with measurement of OH in different neurodegenerative dementias and normal controls (NC).

Methods: 154 patients [50 DLB, 50 Alzheimer’s disease (AD), 54 AD and vascular components (ADvasc)] were examined with systolic and diastolic blood pressure measurements in supine position, immediately after standing up and after 1, 3, 5 and 10 min of standing. They were compared with 50 NC. Orthostatic symptoms were registered according to a predefined protocol.

Results: Twenty-seven percent of all the investigated individuals reported OH symptoms during the measurement while 43% fulfilled the criteria of OH. Sixty-three percent of orthostatic patients did not have any symptoms during the measurement. The prevalence of any orthostatic symptoms during the measurement differed significantly (p<0.001) between the diagnostic groups with 40% in DLB patients, 37% in ADvasc, 28% in AD and 2% in NC. The most frequent symptom was dizziness 13.7%.

Conclusions: Classical orthostatic symptoms are absent in the majority of dementia patients with OH. The orthostatic reaction must therefore be routinely measured in this patient group. This is particularly important for patients with DLB where falls as a result of OH are common. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dementia with Lewy bodies, Alzheimer’s disease, Orthostatic symptoms, Orthostatic hypotension, Falls
in
Clinical Autonomic Research
volume
25
issue
2
pages
87 - 94
publisher
Springer
external identifiers
  • pmid:24743866
  • wos:000353352900002
  • scopus:84939892667
ISSN
1619-1560
DOI
10.1007/s10286-014-0244-z
language
English
LU publication?
yes
id
00219b5c-fb29-4c7d-8ca5-cf6cb0d9e1f9 (old id 4429891)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24743866?dopt=Abstract
date added to LUP
2014-05-05 17:33:35
date last changed
2017-07-09 03:25:27
@article{00219b5c-fb29-4c7d-8ca5-cf6cb0d9e1f9,
  abstract     = {Purpose: Orthostatic hypotension (OH) is common and increases with age. OH is part of the autonomic dysfunction in dementia with Lewy bodies (DLB). Commonly OH is diagnosed when the patient falls which is a risk factor of premature death. Our objective was to systematically investigate the clinical symptoms associated with measurement of OH in different neurodegenerative dementias and normal controls (NC).<br/><br>
Methods: 154 patients [50 DLB, 50 Alzheimer’s disease (AD), 54 AD and vascular components (ADvasc)] were examined with systolic and diastolic blood pressure measurements in supine position, immediately after standing up and after 1, 3, 5 and 10 min of standing. They were compared with 50 NC. Orthostatic symptoms were registered according to a predefined protocol.<br/><br>
Results: Twenty-seven percent of all the investigated individuals reported OH symptoms during the measurement while 43% fulfilled the criteria of OH. Sixty-three percent of orthostatic patients did not have any symptoms during the measurement. The prevalence of any orthostatic symptoms during the measurement differed significantly (p&lt;0.001) between the diagnostic groups with 40% in DLB patients, 37% in ADvasc, 28% in AD and 2% in NC. The most frequent symptom was dizziness 13.7%.<br/><br>
Conclusions: Classical orthostatic symptoms are absent in the majority of dementia patients with OH. The orthostatic reaction must therefore be routinely measured in this patient group. This is particularly important for patients with DLB where falls as a result of OH are common.},
  author       = {Bengtsson Lindberg, Marie and Larsson, Victoria and Minthon, Lennart and Wattmo, Carina and Londos, Elisabet},
  issn         = {1619-1560},
  keyword      = {Dementia with Lewy bodies,Alzheimer’s disease,Orthostatic symptoms,Orthostatic hypotension,Falls},
  language     = {eng},
  number       = {2},
  pages        = {87--94},
  publisher    = {Springer},
  series       = {Clinical Autonomic Research},
  title        = {Lack of orthostatic symptoms in dementia patients with orthostatic hypotension.},
  url          = {http://dx.doi.org/10.1007/s10286-014-0244-z},
  volume       = {25},
  year         = {2015},
}