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Lack of orthostatic symptoms in dementia patients with orthostatic hypotension

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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 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.

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Acknowledgments

This study was supported by Swedish Research Council grant no 523-2010-520, funding from the governmental funding of clinical research within the national health services, the Swedish Parkinson foundation and the Swedish Parkinson Academy.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Simrisbanv. 14, 20502, Malmö, Sweden

    M. Bengtsson-Lindberg, V. Larsson, L. Minthon, C. Wattmo & E. Londos

Authors
  1. M. Bengtsson-Lindberg
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  2. V. Larsson
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  3. L. Minthon
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  4. C. Wattmo
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  5. E. Londos
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Corresponding author

Correspondence to E. Londos.

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Bengtsson-Lindberg, M., Larsson, V., Minthon, L. et al. Lack of orthostatic symptoms in dementia patients with orthostatic hypotension. Clin Auton Res 25, 87–94 (2015). https://doi.org/10.1007/s10286-014-0244-z

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  • DOI: https://doi.org/10.1007/s10286-014-0244-z

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