Orthostatic hypotension in patients with dementia: Clinical features and response to treatment

Cognitive and Behavioral Neurology

Volumn 26, Issue 3, 2013, Pages 105-120

  Freidenberg, Donald L ^a   Shaffer, Lynn E T ^b   MacAlester, Shawn ^c   Fannin, Elizabeth A ^c  

^a RIVERSIDE METHODIST HOSPITAL   (United States)

^b Ohio Health Research and Innovation Institute   (United States)

^c NONE

Author keywords

confusion; dementia; falling; mental fluctuations; orthostatic hypotension

Indexed keywords

ALPHA 2 ADRENERGIC RECEPTOR STIMULATING AGENT; AMITRIPTYLINE; ANALGESIC AGENT; ANGIOTENSIN RECEPTOR ANTAGONIST; ANTICONVULSIVE AGENT; ANTIDEPRESSANT AGENT; ANTIHYPERTENSIVE AGENT; ANTIPARKINSON AGENT; ANTITHROMBOCYTIC AGENT; ATYPICAL ANTIPSYCHOTIC AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CARBAMAZEPINE; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; DOXAZOSIN; DULOXETINE; FLUDROCORTISONE; GABAPENTIN; MIDODRINE; NITRATE; NORTRIPTYLINE; PREGABALIN; PYRIDOSTIGMINE; SODIUM CHLORIDE; TAMSULOSIN; TRAMADOL; TRAZODONE; UNINDEXED DRUG; VASODILATOR AGENT;

AGED; ARTICLE; BLOOD PRESSURE; CLINICAL FEATURE; COMPRESSION STOCKING; CONFUSION; CONSCIOUSNESS; CONTROLLED STUDY; DEMENTIA; DIZZINESS; DROWSINESS; FALLING; FATIGUE; FEMALE; HUMAN; HYPERSOMNIA; LETHARGY; LONG TERM CARE; MAJOR CLINICAL STUDY; MALE; MENTAL DISEASE; ORTHOSTATIC HYPOTENSION; PATIENT MONITORING; PHYSICAL DISEASE BY BODY FUNCTION; PREVALENCE; PRIORITY JOURNAL; RISK FACTOR; TREATMENT RESPONSE;

AGE DISTRIBUTION; AGED; AGED, 80 AND OVER; ALZHEIMER DISEASE; BLOOD PRESSURE MONITORING, AMBULATORY; CHRONIC DISEASE; COMORBIDITY; DEMENTIA; DIAGNOSIS, DIFFERENTIAL; FEMALE; HUMANS; HYPERTENSION; HYPOTENSION, ORTHOSTATIC; LOGISTIC MODELS; LONG-TERM CARE; MALE; MIDDLE AGED; PREVALENCE; QUALITY OF LIFE; RETROSPECTIVE STUDIES; RISK FACTORS; SEX DISTRIBUTION; SPHYGMOMANOMETERS; TREATMENT OUTCOME;

EID: 84885461688     PISSN: 15433633     EISSN: 15370887     Source Type: Journal    
DOI: 10.1097/WNN.0000000000000003     Document Type: Article

References (60)

1. Albert ML. 2005. Subcortical dementia: historical review and personal view. Neurocase. 11:243-245. (Pubitemid 41179593)
2. Allan LM, Ballard CG, Allen J, et al. 2007. Autonomic dysfunction in dementia. J Neurol Neurosurg Psychiatry. 78:671-677. (Pubitemid 46998833)
3. American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders. 4th ed, text rev. Washington, DC: American Psychiatric Association; 147-165.
4. Arbogast SD, Alshekhlee A, Hussain Z, et al. 2009. Hypotension unawareness in profound orthostatic hypotension. Am J Med. 122: 574-580.
5. Aung AK, Corcoran SJ, Nagalingam V, et al. 2012. Prevalence, associations, and risk factors for orthostatic hypotension in medical, surgical, and trauma inpatients: an observational cohort study. Ochsner J. 12:35-41.
6. Baker SP, Harvey AH. 1985. Fall injuries in the elderly. Clin Geriatr Med. 1:501-509.
7. Bos MJ, Van Rijn MJ, Witteman JC, et al. 2007. Incidence and prognosis of transient neurological attacks. JAMA. 298: 2877-2885.
8. Braam EA, Verbakel D, Adiyaman A, et al. 2009. Orthostatic hypotension: revision of the definition is needed. J Hypertens. 27:976-982.
9. Cheshire WP, Phillips LH. 2006. Delayed orthostatic hypotension: is it worth the wait? Neurology. 67:8-9.
10. Cummings JL. 2004. Fluctuations in cognitive function in dementia with Lewy bodies. Lancet Neurol. 3:266. (Pubitemid 38510191)
11. Eigenbrodt ML, Rose KM, Couper DJ, et al. 2000. Orthostatic hypotension as a risk factor for stroke: the atherosclerosis risk in communities (ARIC) study, 1987-1996. Stroke. 31:2307-2313.
12. Ejaz AA, Haley WE, Wasiluk A, et al. 2004. Characteristics of 100 consecutive patients presenting with orthostatic hypotension. Mayo Clin Proc. 79:890-894. (Pubitemid 38879955)
13. Fedorowski A, Hedblad B, Melander O. 2011. Early postural blood pressure response and cause-specific mortality among middle-aged adults. Eur J Epidemiol. 26:537-546.
14. Feldstein C, Weder AB. 2012. Orthostatic hypotension: a common, serious and underrecognized problem in hospitalized patients. J Am Soc Hypertens. 6:27-39.
15. Ferman TJ, Smith GE, Boeve BF, et al. 2004. DLB fluctuations: specific features that reliably differentiate DLB from AD and normal aging. Neurology. 62:181-187. (Pubitemid 38167122)
16. Freeman R. 2008. Clinical practice: neurogenic orthostatic hypotension. N Engl J Med. 358:615-624.
17. Gibbons CH, Freeman R. 2005. Orthostatic dyspnea: a neglected symptom of orthostatic hypotension. Clin Auton Res. 15:40-44. (Pubitemid 40487067)
18. Gibbons CH, Freeman R. 2006. Delayed orthostatic hypotension: a frequent cause of orthostatic intolerance. Neurology. 67:28-32. (Pubitemid 44305457)
19. Glodzik L, Rusinek H, Pirraglia E, et al. 2013. Blood pressure decrease correlates with tau pathology and memory decline in hypertensive elderly. Neurobiol Aging. doi: 10.1016/j.neurobiolaging.2013.06.011.
20. Grubb BP, Kanjwal Y, Karabin B, et al. 2008. Orthostatic hypotension and autonomic failure: a concise guide to diagnosis and management. Clin Med Cardiol. 2:279-291.
21. Grubb BP, Karas B. 1999. Clinical disorders of the autonomic nervous system associated with orthostatic intolerance: an overview of classification, clinical evaluation, and management. Pacing Clin Electrophysiol. 22:798-810. (Pubitemid 29244996)
22. Hall JE. 2011. Guyton and Hall Textbook of Medical Physiology. 12th ed. Philadelphia: Saunders/Elsevier.
23. Hohler AD, Zuzuá rregui JR, Katz DI, et al. 2012. Differences in motor and cognitive function in patients with Parkinson's disease with and without orthostatic hypotension. Int J Neurosci. 122:233-236.
24. Humm AM, Bostock H, Troller R, et al. 2011. Muscle ischaemia in patients with orthostatic hypotension assessed by velocity recovery cycles. J Neurol Neurosurg Psychiatry. 82:1394-1398.
25. Jochemsen H, Muller M, Visseren F, et al. 2012. Blood pressure and progression of brain atrophy-lower is not always better: the SMART-MR study. Alzheimers Dement. 8(suppl):P89.
26. Kamaruzzaman S, Watt H, Carson C, et al. 2010. The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study. Age Ageing. 39:51-56.
27. Kario K, Eguchi K, Hoshide S, et al. 2002. U-curve relationship between orthostatic blood pressure change and silent cerebrovascular disease in elderly hypertensives: orthostatic hypertension as a new cardiovascular risk factor. J Am Coll Cardiol. 40:133-141. (Pubitemid 34701388)
28. Kaufmann H. 1996. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Clin Auton Res. 6:125-126.
29. Kaufmann H, Malamut R, Norcliffe-Kaufmann L, et al. 2012. The Orthostatic Hypotension Questionnaire (OHQ): validation of a novel symptom assessment scale. Clin Auton Res. 22:79-90.
30. Kim JS, Oh YS, Lee KS, et al. 2012. Association of cognitive dysfunction with neurocirculatory abnormalities in early Parkinson disease. Neurology. 79:1323-1331.
31. Lipsitz LA. 1989. Orthostatic hypotension in the elderly. N Engl J Med. 321:952-957.
32. Lopez OL, Swihart AA, Becker JT, et al. 1990. Reliability of NINCDSADRDA clinical criteria for the diagnosis of Alzheimer's disease. Neurology. 40:1517-1522. (Pubitemid 20351342)
33. Low PA, Bloomfield DM, Gilden JL, et al . 1997. Advances in the diagnosis and treatment of orthostatic hypotension and selected syncopal conditions [continuing medical education learning kit sponsored and accredited by the Dannemiller Memorial Educational Foundation, San Antonio, TX; produced by American Medical Communications, Morganville, NJ; and funded by Roberts Pharmaceuticals, Eatontown, NJ].
34. Low PA, Opfer-Gehrking TL, McPhee BR, et al. 1995. Prospective evaluation of clinical characteristics of orthostatic hypotension. Mayo Clin Proc. 70:617-622.
35. Lyons KE, Pahwa R. 2011. The impact and management of nonmotor symptoms of Parkinson's disease. Am J Manag Care. 17(suppl 12): S308-S314.
36. Mader SL. 1989. Orthostatic hypotension. Med Clin North Am. 73: 1337-1349. (Pubitemid 19285139)
37. Mader SL. 2012. Identification and management of orthostatic hypotension in older and medically complex patients. Expert Rev Cardiovasc Ther. 10:387-395.
38. Masaki KH, Schatz IJ, Burchfiel CM, et al. 1998. Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program. Circulation. 98:2290-2295. (Pubitemid 28533848)
39. Mathias CJ, Mallipeddi R, Bleasdale-Barr K. 1999. Symptoms associated with orthostatic hypotension in pure autonomic failure and multiple system atrophy. J Neurol. 246:893-898. (Pubitemid 29512158)
40. Maule S, Caserta M, Bertello C, et al. 2008. Cognitive decline and low blood pressure: the other side of the coin. Clin Exp Hypertens. 30:711-719.
41. McKeith IG, Galasko D, Kosaka K, et al. 1996. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology. 47:1113-1124. (Pubitemid 26374873)
42. Mendu ML, McAvay G, Lampert R, et al. 2009. Yield of diagnostic tests in evaluating syncopal episodes in older patients. Arch Intern Med. 168:1299-1305.
43. Mehrabian S, Duron E, Labouree F, et al. 2010. Relationship between orthostatic hypotension and cognitive impairment in the elderly. J Neurol Sci. 299:45-48.
44. Mosnaim AD, Abiola R, Wolf ME, et al. 2010. Etiology and risk factors for developing orthostatic hypotension. Am J Ther. 17:86-91.
45. Muller M, Gudnason V, Aspelund T, et al. 2012. The combined effect of midlife hypertension status and late-life blood pressure on brain volumes: the AGES-Reykjavik Study. Alzheimers Dement. 8(suppl): P88.
46. Muller M, van der Graaf Y, Visseren FL, et al. 2010. Blood pressure, cerebral blood flow, and brain volumes: the SMART-MR study. J Hypertens. 28:1498-1505.
47. Novak P. 2011. Assessment of sympathetic index from the Valsalva maneuver. Neurology. 76:2010-2016.
48. Ooi WL, Barrett S, Hossain M, et al. 1997. Patterns of orthostatic blood pressure change and their clinical correlates in a frail, elderly population. JAMA. 277:1299-1304. (Pubitemid 27194354)
49. Raiha I, Tarvonen S, Kurki T, et al. 1993. Relationship between vascular factors and white matter low attenuation of the brain. Acta Neurol Scand. 87:286-289. (Pubitemid 23122222)
50. Robertson D, Kincaid DW, Haile V, et al. 1994. The head and neck discomfort of autonomic failure: an unrecognized aetiology of headache. Clin Auton Res. 4:99-103. (Pubitemid 24249624)
51. Rose KM, Eigenbrodt ML, Biga RL, et al. 2006. Orthostatic hypotension predicts mortality in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 114:630-636. (Pubitemid 44252304)
52. Rutan GH, Hermanson B, Bild DE, et al. 1992. Orthostatic hypotension in older adults: the Cardiovascular Health Study: CHS Collaborative Research Group. Hypertension. 19:508-519.
53. Shibao C, Grijalva CG, Raj SR, et al. 2007. Orthostatic hypotensionrelated hospitalizations in the United States. Am J Med. 120:975-980. (Pubitemid 47633484)
54. Siennicki-Lantz A, Lilja B, Elmstahl S. 1999. Orthostatic hypotension in Alzheimer's disease: result or cause of brain dysfunction? Aging. 11:155-160. (Pubitemid 29446277)
55. Sonnesyn H, Nilsen DW, Rongve A, et al. 2009. High prevalence of orthostatic hypotension in mild dementia. Dement Geriatr Cogn Disord. 28:307-313.
56. Streeten DH, Anderson GH Jr. 1992. Delayed orthostatic intolerance. Arch Intern Med. 52:1066-1072.
57. Tilvis RS, Hakala SM, Valvanne J, et al. 1996. Postural hypotension and dizziness in a general aged population: a four-year follow-up of the Helsinki Aging Study. J Am Geriatr Soc. 44:809-814. (Pubitemid 26238724)
58. van Nieuwenhuizen RC, van Dijk N, van Breda FG, et al. 2010. Assessing the prevalence of modifiable risk factors in older patients visiting an ED due to a fall using the CAREFALL Triage Instrument. Am J Emerg Med. 28:994-1001.
59. Ward C, Kenny RA. 1996. Reproducibility of orthostatic hypotension in symptomatic elderly. Am J Med. 100:418-422. (Pubitemid 26115196)
60. Wieling W, Schatz IJ. 2009. The consensus statement on the definition of orthostatic hypotension: a revisit after 13 years. J Hypertens. 27: 935-938.