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Orthostatic hypotension in Alzheimer's disease : Result or cause of brain dysfunction?

Siennicki-Lantz, A. LU orcid ; Lilja, B. and Elmståhl, S. LU (1999) In Aging clinical and experimental research 11(3). p.155-160
Abstract

In Alzheimer's disease (AD), an association was found between autonomic dysfunction and frontal hypoperfusion in brain during orthostatic testing. To ascertain whether frontal hypoperfusion is dependent on longitudinal effects of hemodynamic disturbances, or contributes to them, we studied the relationship between the presence of orthostatic hypotension (OH) and resting cerebral blood flow (CBF) in late stages of AD. Twelve women with senile dementia of Alzheimer type (SDAT), and 15 non-demented women (mean age 82.6 years, SD 3.8 vs 81.8 years, SD 3.5) were examined with the orthostatic test. Four of 12 patients with SDAT, and 9 controls had OH (defined as systolic blood pressure fall ≥ 20 mmHg). CBF was determined under resting... (More)

In Alzheimer's disease (AD), an association was found between autonomic dysfunction and frontal hypoperfusion in brain during orthostatic testing. To ascertain whether frontal hypoperfusion is dependent on longitudinal effects of hemodynamic disturbances, or contributes to them, we studied the relationship between the presence of orthostatic hypotension (OH) and resting cerebral blood flow (CBF) in late stages of AD. Twelve women with senile dementia of Alzheimer type (SDAT), and 15 non-demented women (mean age 82.6 years, SD 3.8 vs 81.8 years, SD 3.5) were examined with the orthostatic test. Four of 12 patients with SDAT, and 9 controls had OH (defined as systolic blood pressure fall ≥ 20 mmHg). CBF was determined under resting conditions using 600 Mbq 99mTc HMPAO single photon emission computerized tomography (SPECT), and quantified in cortical areas in relation to cerebellum. In patients with SDAT and OH, CBF was lower in frontal and parieto-frontal cortical areas than in SDAT patients without OH. The former group was younger and had a shorter dementia duration. No significant differences in CBF were observed between controls with vs without OH. No differences in SDAT patients with or without OH were observed in the Berger dementia scale or Katz' ADL index. No difference in incidence of symptoms related to autonomic disturbances (diarrhea, obstipation, dysphagia, vertigo) was observed in either the SDAT or control group with regard to OH presence. We conclude that during the course of AD, OH can contribute to frontal brain changes and may exacerbate the disease. The further involvement of frontal dysfunction in aggravating blood pressure dysregulation in the elderly is discussed.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alzheimer's disease, Autonomic dysfunction, Cerebral blood flow, Dementia, Orthostatic hypotension
in
Aging clinical and experimental research
volume
11
issue
3
pages
155 - 160
publisher
Kurtis
external identifiers
  • scopus:0032829295
  • pmid:10476310
ISSN
0394-9532
language
English
LU publication?
yes
id
f0582e2a-db9f-4281-b30c-7cf56c05ecfc
alternative location
https://link.springer.com/article/10.1007%2FBF03399657
date added to LUP
2019-06-19 11:05:08
date last changed
2024-01-01 11:19:30
@article{f0582e2a-db9f-4281-b30c-7cf56c05ecfc,
  abstract     = {{<p>In Alzheimer's disease (AD), an association was found between autonomic dysfunction and frontal hypoperfusion in brain during orthostatic testing. To ascertain whether frontal hypoperfusion is dependent on longitudinal effects of hemodynamic disturbances, or contributes to them, we studied the relationship between the presence of orthostatic hypotension (OH) and resting cerebral blood flow (CBF) in late stages of AD. Twelve women with senile dementia of Alzheimer type (SDAT), and 15 non-demented women (mean age 82.6 years, SD 3.8 vs 81.8 years, SD 3.5) were examined with the orthostatic test. Four of 12 patients with SDAT, and 9 controls had OH (defined as systolic blood pressure fall ≥ 20 mmHg). CBF was determined under resting conditions using 600 Mbq <sup>99m</sup>Tc HMPAO single photon emission computerized tomography (SPECT), and quantified in cortical areas in relation to cerebellum. In patients with SDAT and OH, CBF was lower in frontal and parieto-frontal cortical areas than in SDAT patients without OH. The former group was younger and had a shorter dementia duration. No significant differences in CBF were observed between controls with vs without OH. No differences in SDAT patients with or without OH were observed in the Berger dementia scale or Katz' ADL index. No difference in incidence of symptoms related to autonomic disturbances (diarrhea, obstipation, dysphagia, vertigo) was observed in either the SDAT or control group with regard to OH presence. We conclude that during the course of AD, OH can contribute to frontal brain changes and may exacerbate the disease. The further involvement of frontal dysfunction in aggravating blood pressure dysregulation in the elderly is discussed.</p>}},
  author       = {{Siennicki-Lantz, A. and Lilja, B. and Elmståhl, S.}},
  issn         = {{0394-9532}},
  keywords     = {{Alzheimer's disease; Autonomic dysfunction; Cerebral blood flow; Dementia; Orthostatic hypotension}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{155--160}},
  publisher    = {{Kurtis}},
  series       = {{Aging clinical and experimental research}},
  title        = {{Orthostatic hypotension in Alzheimer's disease : Result or cause of brain dysfunction?}},
  url          = {{https://link.springer.com/article/10.1007%2FBF03399657}},
  volume       = {{11}},
  year         = {{1999}},
}