Background: It is crucial to evaluate the causes of morbidity and mortality in elderly patients with dementia, such as orthostatic hypotension (OH), which may affect their daily life activities, reduce the quality of life, and increase the caregiver burden. Objective: We aimed to investigate the relationship between OH and the most common subtypes of dementia in detail. Methods: A total of 268 older adults with dementia diagnosed with Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), vascular dementia (VaD), and behavioral variant frontotemporal dementia (bvFTD), and 539 older adults without dementia were included in this prospective study. Comprehensive geriatric assessment including comorbidity, medication evaluation, and the head-up tilt test was also performed. Results: Of the participants, 13.8, 8.3, 6.4, and 4.8% had AD, DLB, bvFTD, and VaD, respectively. After adjusting for age, gender, the presence of comorbidities, and usage of OH-induced drugs; AD, DLB, and VaD were associated with OH (odds ratio [OR]: 2.23 confidence interval [CI] 95% 1.31–3.80; p = 0.003; OR: 3.68 CI 95% 1.98–6.83; p #x3c; 0.001, and OR: 3.56 CI 95% 1.46–8.69; p = 0.005, respectively). Furthermore, VaD was independently related to diastolic OH (OR: 4.19 CI 95% 1.66–10.57; p = 0.002), whereas AD and DLB were not. Conclusions: This study shows that elderly patients with DLB, AD, and VaD often have OH, a disabling autonomic dysfunction feature. Moreover, diastolic OH may play a role in the development of VaD. Therefore, considering potential complications of OH, it is essential to evaluate OH in the follow-up and management of those patients.
Dement Geriatr Cogn Disord

中文翻译：

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老年痴呆症最常见亚型与体位性低血压之间的关系

背景：评估老年痴呆患者发病和死亡的原因至关重要，例如直立性低血压（OH），这可能影响他们的日常生活活动，降低生活质量，增加照顾者的负担。目的：我们旨在详细调查 OH 与最常见的痴呆亚型之间的关系。方法：该前瞻性研究共纳入了 268 名被诊断为阿尔茨海默病 (AD)、路易体痴呆 (DLB)、血管性痴呆 (VaD) 和行为变异性额颞叶痴呆 (bvFTD) 的老年痴呆症患者，以及 539 名未患痴呆症的老年人学习。还进行了全面的老年评估，包括合并症、药物评估和抬头倾斜试验。结果：在参与者中，分别有 13.8%、8.3%、6.4% 和 4.8% 患有 AD、DLB、bvFTD 和 VaD。在调整年龄、性别、合并症和 OH 诱导药物的使用后；AD、DLB 和 VaD 与 OH 相关（优势比 [OR]：2.23 置信区间 [CI] 95% 1.31–3.80；p = 0.003；OR：3.68 CI 95% 1.98–6.83；p#x3c; 0.001，或：3.56 CI 95% 1.46–8.69；p = 0.005，分别）。此外，VaD 与舒张 OH 独立相关（OR：4.19 CI 95% 1.66–10.57；p = 0.002），而 AD 和 DLB 则不然。结论：本研究表明，患有 DLB、AD 和 VaD 的老年患者通常患有 OH，这是一种致残的自主神经功能障碍特征。此外，舒张 OH 可能在 VaD 的发展中起作用。因此，考虑到 OH 的潜在并发症，在这些患者的随访和管理中评估 OH 是必不可少的。
老年痴呆症认知障碍