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. 2014 Jul 23;4(2):283-96.
doi: 10.1159/000363514. eCollection 2014 May-Aug.

Persistence and Prognostic Implications of Orthostatic Hypotension in Older Individuals with Mild-to-Moderate Dementia

Hogne Soennesyn  1 , Ingvild Dalen  1 , Dag Aarsland  1
Affiliations

Persistence and Prognostic Implications of Orthostatic Hypotension in Older Individuals with Mild-to-Moderate Dementia

Hogne Soennesyn et al. Dement Geriatr Cogn Dis Extra. .

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.

Keywords: Dementia; Orthostatic hypotension; Survival analysis.

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Figures

Fig. 1
Fig. 1
OH classification flow chart.
Fig. 2
Fig. 2
Observed survival for the OH+ group (grey) and for the OH-group (black).
Fig. 3
Fig. 3
Box plot of MMSE scores from baseline (BL) to 4-year follow-up (FU4). Light grey: patients with OH at each examination. Dark grey: patients without OH at each examination.
Fig. 4
Fig. 4
Box plot of CDR-SB scores from baseline (BL) to 4-year follow-up (FU4). Light grey: patients with OH at each examination. Dark grey: patients without OH at each examination.
Fig. 5
Fig. 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).
Fig. 6
Fig. 6
Course of CDR-SB 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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