Orthostatic hypotension and dementia incidence: links and implications

22Citations
Citations of this article
59Readers
Mendeley users who have this article in their library.

Abstract

Orthostatic hypotension (OH) is a common condition, particularly in patients with α-synucleinopathies such as Parkinson’s disease, and has a significant impact on activities of daily living and quality of life. Recent data suggest an association with cognitive impairment. Herein, we review the evidence that OH increases the odds of incident mild cognitive impairment and dementia. Potential mechanisms underlying the putative relationship are discussed, including cerebral hypoperfusion, supine hypertension, white matter hyperintensities, and neurodegeneration. Finally, we highlight the challenges with respect to treatment and the negative impact on the quality of life and long-term prognosis presented by the coexistence of OH and dementia. Large population-based studies have reported that OH is associated with about a 20% increased risk of dementia in the general population, while smaller cohort studies suggest an even greater effect in patients with α-synucleinopathies (3-to 7-fold higher than controls). Ultimately, OH exposure is difficult to quantify, predominantly limited to pressure regulation during a one-time orthostatic challenge, and the causative association with dementia may turn out to be bidirectional, especially in α-synucleinopathies. Early diagnosis and treatment of OH may improve long-term prognosis.

Cite

CITATION STYLE

APA

Robertson, A. D., Udow, S. J., Espay, A. J., Merola, A., Camicioli, R., Lang, A. E., & Masellis, M. (2019). Orthostatic hypotension and dementia incidence: links and implications. Neuropsychiatric Disease and Treatment. Dove Medical Press Ltd. https://doi.org/10.2147/NDT.S182123

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free