The Relationship between the Most Common Subtypes of Dementia and Orthostatic Hypotension in Older Adults

Işık, Ahmet Turan; Koçyiğit, Süleyman Emre; Kaya, Derya; Günay, Fatma Sena Dost; Erken, Neziha; Dokuzlar, Özge; Aydın, Ali Ekrem; Bulut, Esra Ateş

doi:10.1159/000513978

Cited by 10 publications

(7 citation statements)

References 37 publications

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“…The recent meta-analysis of Isik et al showed that the risk of finding OH in patients with Alzheimer's disease is multiplied by 2.5 compared to healthy people [26]. Most previous studies reported a positive association, orthostatic hypotension being associated with cognitive impairment or cognitive decline [27][28][29][30][31][32]. However, a significant number of studies could not report any association of OH with cognitive performance, cerebral blood flow or cerebral damage [33,34].…”

Section: Discussionmentioning

confidence: 99%

Orthostatic hypotension and neurocognitive disorders in older women: Results from the EPIDOS cohort study

et al. 2023

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Background Although it is well-admitted that cardiovascular health affects cognition, the association between orthostatic hypotension (OH) and cognition remains unclear. The objectives of the present study were i) to determine among the EPIDOS cohort (EPIdémiologie de l’OStéoporose) whether OH was cross-sectionally associated with cognitive impairment at baseline, and ii) whether baseline OH could predict incident cognitive decline after 7 years of follow-up. Methods Systolic and Diastolic Blood Pressure (SBP and DBP) changes while standing (ie, ΔSBP and ΔDBP, in %) were measured at baseline among 2,715 community-dwelling older women aged 75 years and older using no antihypertensive drugs from the French EPIDOS cohort. OH was defined as a decrease in SBP ≥20 mmHg and/or a decrease in DBP ≥10 mmHg within 3 min after standing. Cognitive impairment was defined as a Short Portable Mental Status Questionnaire (SPMSQ) score <8 (/10). Among those without cognitive impairment at baseline, a possible incident onset of cognitive decline was then sought after 7 years of follow-up among 257 participants. Results Baseline ΔSBP was associated with baseline cognitive impairment (adjusted OR = 1.01, p = 0.047), but not with incident onset of cognitive decline after 7 years (adjusted OR = 0.98, p = 0.371). Neither baseline OH nor baseline ΔDBP were associated with cognitive impairment neither at baseline (p = 0.426 and p = 0.325 respectively) nor after 7 years (p = 0.180 and p = 0.345 respectively). Conclusions SBP drop while standing, but neither OH per se nor DBP drop while standing, was associated with baseline cognitive impairment in older women. The relationship between OH and cognitive impairment appears more complex than previously expected.

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Section: Discussionmentioning

confidence: 99%

Orthostatic hypotension and neurocognitive disorders in older women: Results from the EPIDOS cohort study

et al. 2023

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“…These may manifest in DLB prior to onset of dementia 3 and so could be an early marker of a “bottom‐up” staged prodromal synucleinopathy 4 . However, identifying autonomic symptoms is complicated by the range of causes of these in older adults, in particular these symptoms may occur in other forms of dementia such as Alzheimer's disease (AD), 5 and so are not specific to DLB 6,7 …”

Section: Introductionmentioning

confidence: 99%

“…2 These may manifest in DLB prior to onset of dementia 3 and so could be an early marker of a "bottom-up" staged prodromal synucleinopathy. 4 However, identifying autonomic symptoms is complicated by the range of causes of these in older adults, in particular these symptoms may occur in other forms of dementia such as Alzheimer's disease (AD), 5 and so are not specific to DLB. 6,7 Recent efforts have led to the characterisation of the cognitive prodrome of DLB -mild cognitive impairment (MCI) with Lewy bodies (MCI-LB) -in research settings, with autonomic symptoms included as supportive clinical features.…”

Section: Introductionmentioning

confidence: 99%

Assessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies

Hamilton

Frith

Donaghy

et al. 2022

Int J Geriat Psychiatry

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Objectives Autonomic symptoms are a common feature of the synucleinopathies, and may be a distinguishing feature of prodromal Lewy body disease. We aimed to assess whether the cognitive prodrome of dementia with Lewy bodies, mild cognitive impairment (MCI) with Lewy bodies (MCI‐LB), would have more severe reported autonomic symptoms than cognitively healthy older adults, with MCI due to Alzheimer's disease (MCI‐AD) also included for comparison. We also aimed to assess the utility of an autonomic symptom scale in differentiating MCI‐LB from MCI‐AD. Methods Ninety‐three individuals with MCI and 33 healthy controls were assessed with the Composite Autonomic Symptom Score 31‐item scale (COMPASS). Mild cognitive impairment patients also underwent detailed clinical assessment and differential classification of MCI‐AD or MCI‐LB according to current consensus criteria. Differences in overall COMPASS score and individual symptom sub‐scales were assessed, controlling for age. Results Age‐adjusted severity of overall autonomic symptomatology was greater in MCI‐LB (Ratio = 2.01, 95% CI: 1.37–2.96), with higher orthostatic intolerance and urinary symptom severity than controls, and greater risk of gastrointestinal and secretomotor symptoms. MCI‐AD did not have significantly higher autonomic symptom severity than controls overall. A cut‐off of 4/5 on the COMPASS was sensitive to MCI‐LB (92%) but not specific to this (42% specificity vs. MCI‐AD and 52% vs. healthy controls). Conclusions Mild cognitive impairment with Lewy bodies had greater autonomic symptom severity than normal ageing and MCI‐AD, but such autonomic symptoms are not a specific finding. The COMPASS‐31 may therefore have value as a sensitive screening test for early‐stage Lewy body disease.

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“…Furthermore, many comorbid conditions, such as hypertension, diabetes mellitus, coronary artery disease, orthostatic hypotension, urinary incontinence, polypharmacy and falls, can accompany dementia in older adults 2 . Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are the most common causes of dementia in geriatric patients, and other comorbid conditions accompanying AD and DLB in older patients adversely affect the course of these two diseases 1–6 …”

Section: Introductionmentioning

confidence: 99%

“…2 Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are the most common causes of dementia in geriatric patients, and other comorbid conditions accompanying AD and DLB in older patients adversely affect the course of these two diseases. [1][2][3][4][5][6] Sarcopenia, one of the other common geriatric syndromes, is also related to several negative health outcomes and socioeconomic burdens in older adults, which is characterized by an agerelated decline in skeletal muscle mass and low muscle strength, with or without low physical performance. 7 Furthermore, it might lead to many adverse outcomes, such as falls, fractures, limitation in activities of daily living, disability, increase in hospitalization and mortality, and its prevalence can vary from 9.9% to 40.4% in older adults.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia is as common in older patients with dementia with Lewy bodies as it is in those with Alzheimer's disease

Dost

Bulut

Dokuzlar

et al. 2022

Geriatrics Gerontology Int

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Alzheimer's disease (AD) and dementia with Lewy body (DLB) constitute the most common types of dementia, and are two common geriatric syndromes; however, sarcopenia has not been elaborately evaluated in DLB so far. Therefore, this study aimed to investigate the relationship between sarcopenia and DLB in older adults.Methods: In this retrospective and cross-sectional study, 662 participants, who were followed in a memory clinic at the Geriatrics department of a university hospital, were included. Comprehensive Geriatric Assessment, including the activities of daily living, malnutrition and malnutrition risk, frailty, cognition, and sarcopenia were assessed. Sarcopenia was defined according to the revised European Working Group on Sarcopenia in Older People-2 criteria.Results: A total of 662 participants (461 healthy controls, 133 with AD and 68 with DLB) with a mean age of 73.60 AE 7.50 years were included. The prevalence of probable sarcopenia and sarcopenia was 53.4% and 19.5%, respectively, in patients with AD, whereas it was 55.9% and 19.1%, respectively, in patients with DLB. After adjustment analyses, probable sarcopenia, sarcopenia and low muscle mass were related to AD (P < 0.001, P = 0.001, P < 0.001, respectively). Probable sarcopenia and slow gait speed were associated with DLB (P < 0.01, P < 0.001, respectively).Conclusions: Sarcopenia is common in patients with DLB and in those with AD, and seems to be closely related to low muscle strength and slow gait speed in DLB patients. Considering sarcopenia-related negative health outcomes in older adults, the evaluation of sarcopenia, therefore, should also be among the follow-up and treatment goals of DLB patients.

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The Relationship between the Most Common Subtypes of Dementia and Orthostatic Hypotension in Older Adults

Cited by 10 publications

References 37 publications

Orthostatic hypotension and neurocognitive disorders in older women: Results from the EPIDOS cohort study

Orthostatic hypotension and neurocognitive disorders in older women: Results from the EPIDOS cohort study

Assessment of autonomic symptoms may assist with early identification of mild cognitive impairment with Lewy bodies

Sarcopenia is as common in older patients with dementia with Lewy bodies as it is in those with Alzheimer's disease

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