Orthostatic blood pressure changes and physical, functional and cognitive performance: the MELoR study

Saedon, Nor Izzati; Frith, James; Goh, Choon-Hian; Ahmad, Wan Azman Wan; Khor, Hui Min; Tan, Kit Mun; Chin, Ai-Vyrn; Kamaruzzaman, Shahrul Bahyah; Tan, Maw Pin

doi:10.1007/s10286-019-00647-3

Cited by 22 publications

(36 citation statements)

References 22 publications

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“…When comparing the overall SBP changes from baseline between W1 and W3, the major difference was that the depth of the initial drop seemed deeper at W1 than at W3. Recently, the Malaysian Elders Longitudinal Research (MELoR) study found that people with an immediate drop had better physical performance and were less likely to be frail [25].…”

Section: Discussionmentioning

confidence: 99%

Eight Orthostatic Haemodynamic Patterns in The Irish Longitudinal Study on Ageing (TILDA): Stability and Clinical Associations after 4 Years

et al. 2021

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Previous research cross-sectionally characterised eight morphological systolic blood pressure (SBP) active stand (AS) patterns using a clinical clustering approach at Wave 1 (W1) of the Irish Longitudinal Study on Ageing. We explored the longitudinal stability and clinical associations of these groupings at Wave 3 (W3), four years later. Eight AS groups had their clinical characteristics and AS patterns at W3 compared to W1. We explored longitudinal associations (new cognitive decline, falls, syncope, disability, and mortality) using multivariate logistic regression models. In total, 2938 participants (60% of Wave 1 sample) had adequate AS data from both W1 and 3 for analysis. We found no longitudinal stability of the eight AS groups or their morphological patterns between the waves. A pattern of impaired stabilisation and late deficit seemed more preserved and was seen in association with new cognitive decline (OR 1.63, 95% CI: 1.12–2.36, p = 0.011). An increase in antihypertensive usage seemed associated with reduced immediate SBP drops, improved AS patterns, and reduced orthostatic intolerance (OI). In pure longitudinal groups, AS patterns were not preserved after 4 years. AS patterns are longitudinally dynamic, and improvements after 4 years are possible even in the presence of higher antihypertensive burden.

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Section: Discussionmentioning

confidence: 99%

Eight Orthostatic Haemodynamic Patterns in The Irish Longitudinal Study on Ageing (TILDA): Stability and Clinical Associations after 4 Years

et al. 2021

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“…In this issue of Clinical Autonomic Research, Saedon et al report the results of the Malaysian Elders Longitudinal Research (MELoR) study [4]. They evaluated the association between postural changes in blood pressure and physical, functional, and cognitive performance in 1245 community-dwelling Asian elders (mean age 67 years), with a relatively low baseline blood pressure (mean 113/69 mmHg).…”

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confidence: 99%

Delayed recovery from initial orthostatic hypotension: an expression of frailty in the elderly

2020

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“…A total of 5,465 participants (54.5% females ranging between 43.0 and 71.7%) with a mean age ranging between 67.8 ± 6.1 and 84.2 ± 0.9 years, representing the general population ( n = 4,157) [ 16–18 ], geriatric outpatients ( n = 1,136) [ 4 , 10 , 19–24 ], institutionalised population ( n = 55) [ 7 ] and mixed population ( n = 117) [ 5 ], were included. Ten studies were cross-sectional ( n = 4,914) [ 4 , 5 , 10 , 16 , 18–22 , 24 ] and three studies were longitudinal ( n = 551) [ 7 , 17 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…The diagnosis of initial OH included the presence of symptoms in three articles [ 4 , 16 , 20 ] and the recovery of blood pressure within 30–60 seconds in one article [ 10 ]. Blood pressure was measured continuously using Finometer Pro [ 4 , 5 , 7 , 16 , 17 , 20 , 22 , 23 ], Nexfin [ 21 , 24 ] and Task Force CNSystems [ 18 ] or intermittently using either a digital sphygmomanometer [ 19 ] or manual sphygmomanometer [ 10 ]. The resting period prior to postural change varied between 5 [ 10 , 18 , 20–22 , 24 ], 10 [ 4 , 5 , 16 , 17 , 19 , 23 ] and 15 minutes [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

“…Blood pressure was measured continuously using Finometer Pro [ 4 , 5 , 7 , 16 , 17 , 20 , 22 , 23 ], Nexfin [ 21 , 24 ] and Task Force CNSystems [ 18 ] or intermittently using either a digital sphygmomanometer [ 19 ] or manual sphygmomanometer [ 10 ]. The resting period prior to postural change varied between 5 [ 10 , 18 , 20–22 , 24 ], 10 [ 4 , 5 , 16 , 17 , 19 , 23 ] and 15 minutes [ 7 ]. Standing or sitting period varied between 2 [ 16 ], 3 [ 4 , 5 , 10 , 17 , 18 , 21–24 ], 4 [ 20 ], 10 [ 19 ] and 15 minutes [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

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Prevalence of initial orthostatic hypotension in older adults: a systematic review and meta-analysis

et al. 2021

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Background Initial orthostatic hypotension (OH) is a clinical syndrome of exaggerated transient orthostasis associated with higher risks of falls, frailty and syncope in older adults. Objective To provide a prevalence estimate of initial OH in adults aged 65 years or older. Methods Literature search of MEDLINE (from 1946), Embase (from 1947) and Cochrane Central Register of Controlled Trials was performed until 6 December 2019, using the terms ‘initial orthostatic hypotension’, ‘postural hypotension’ and ‘older adults’. Articles were included if published in English and participants were 65 years or older. Random effects models were used for pooled analysis. Results Of 5,136 articles screened, 13 articles (10 cross-sectional; 3 longitudinal) reporting data of 5,465 individuals (54.5% female) from the general (n = 4,157), geriatric outpatient (n = 1,136), institutionalised (n = 55) and mixed (n = 117) population were included. Blood pressure was measured continuously and intermittently in 11 and 2 studies, respectively. Pooled prevalence of continuously measured initial OH was 29.0% (95% CI: 22.1–36.9%, I2 = 94.6%); 27.8% in the general population (95% CI: 17.9–40.5%, I2 = 96.1%), 35.2% in geriatric outpatients (95% CI: 24.2–48.1%, I2 = 95.3%), 10.0% in institutionalised individuals (95% CI: 2.4–33.1%, I2 = 0%) and 21.4% in the mixed population (95% CI: 7.0–49.6, I2 = 0%). Pooled prevalence of intermittently measured initial OH was 5.6% (95% CI: 1.5–18.9%, I2 = 81.1%); 1.0% in the general population (95% CI: 0.0–23.9%, I2 = 0%) and 7.7% in geriatric outpatients (95% CI: 1.8–27.0%, I2 = 86.7%). Conclusion The prevalence of initial OH is high in older adults, especially in geriatric outpatients. Proper assessment of initial OH requires continuous blood pressure measurements.

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Orthostatic blood pressure changes and physical, functional and cognitive performance: the MELoR study

Cited by 22 publications

References 22 publications

Eight Orthostatic Haemodynamic Patterns in The Irish Longitudinal Study on Ageing (TILDA): Stability and Clinical Associations after 4 Years

Eight Orthostatic Haemodynamic Patterns in The Irish Longitudinal Study on Ageing (TILDA): Stability and Clinical Associations after 4 Years

Delayed recovery from initial orthostatic hypotension: an expression of frailty in the elderly

Prevalence of initial orthostatic hypotension in older adults: a systematic review and meta-analysis

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