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Published in: Neurological Sciences 2/2022

01-02-2022 | Hypotension | Original Article

Orthostatic hypotension in patients with Alzheimer’s disease: a meta-analysis of prospective studies

Authors: Ahmet Turan Isik, Neziha Erken, Idil Yavuz, Derya Kaya, Mehmet Selman Ontan, Esra Ates Bulut, Fatma Sena Dost

Published in: Neurological Sciences | Issue 2/2022

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Abstract

Background

Orthostatic hypotension (OH) is a clinical sign associated with severe adverse health outcomes in older adults. It has been reported to be common in patients with Alzheimer’s disease (AD). The present meta-analysis aimed to investigate the prevalence and risk of OH in AD patients.

Methods

English-language articles published from January 1990 to August 2020 were searched in PubMed, ScienceDirect, Cochrane, and Web of Science with the keywords “Alzheimer” and “autonomic dysfunction” or “dysautonomia” or “postural hypotension” or “orthostatic hypotension.” All prospective clinical studies (case–control, cohort, and cross-sectional studies, and randomized controlled trials) that were regarded as pertinent were included in this study. For quality assessment, the Newcastle–Ottawa Scale was used. Odds ratios (OR) and risk ratios (RR) were extracted with 95% confidence intervals (CI) and combined using the random effects model after logarithmic transformation. The prevalence in the AD patients was also combined using the random effects model.

Results

The meta-analysis involved 11 studies (7 case–control and 4 case series) to assess the risk of OH in AD. It was found that AD increased the risk of OH with an RR of 1.98 (95% CI: 0.97–4.04) and an OR of 2.53 (95% CI:1.10–5.86) compared to healthy controls, and OH was present in 28% (95% CI: 0.17–0.40) of 500 AD patients.

Conclusion

There is an elevated risk of OH in AD by nearly 2.5-fold. Therefore, the evaluation of postural blood pressure changes should definitely be among the follow-up and treatment goals of AD.
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Metadata
Title
Orthostatic hypotension in patients with Alzheimer’s disease: a meta-analysis of prospective studies
Authors
Ahmet Turan Isik
Neziha Erken
Idil Yavuz
Derya Kaya
Mehmet Selman Ontan
Esra Ates Bulut
Fatma Sena Dost
Publication date
01-02-2022
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 2/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-021-05450-5

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