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- Title
Associations of Orthostatic Hypotension and Frailty With Dementia and Mortality in Older Adults: A Population-Based Cohort Study.
- Authors
Xia, Xin; Jönsson, Linus; Tazzeo, Clare; Qiu, Chengxuan; Rizzuto, Debora; Laukka, Erika J; Grande, Giulia; Fratiglioni, Laura; Vetrano, Davide Liborio
- Abstract
Background This study aimed to assess the associations of orthostatic hypotension (OH), in the presence or absence of frailty, with dementia and mortality in older adults. Methods We conducted a 15-year population-based cohort study including 2 703 baseline dementia-free individuals from the Swedish National Study on Aging and Care in Kungsholmen. At baseline, OH was defined as a decline in systolic/diastolic blood pressure ≥20/10 mm Hg 1 minute after standing up from a supine position. Frailty status was defined following Fried's frailty phenotype. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders-fourth edition criteria. Multistate flexible parametric survival models were used to estimate associations of OH and frailty with dementia and mortality. Results Robust people with OH (adjusted hazard ratio [HR] = 2.28; 95% confidence interval [CI] = 1.47–3.54) and frail people without OH (HR = 1.98; 95% CI = 1.40–2.82) or with OH (HR = 2.73; 95% CI = 1.82–4.10) had a higher dementia risk than OH-free and robust people. Moreover, frail people, independently of the presence of OH, had higher mortality rate than OH-free and robust people. In individuals who developed dementia during the follow-up period, neither OH nor frailty was significantly associated with mortality. Conclusions Older adults with OH, whether robust or frail, may have a higher dementia risk than those without OH. Older adults with OH, when having frailty, may have a higher mortality rate than those without OH. The concurrent assessments of OH and frailty may provide prognostic values in terms of dementia and mortality risk in older adults.
- Subjects
DIAGNOSTIC & Statistical Manual of Mental Disorders (Book); OLDER people; ORTHOSTATIC hypotension; FRAILTY; COHORT analysis; DIASTOLIC blood pressure
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2024, Vol 79, Issue 4, p1
- ISSN
1079-5006
- Publication type
Academic Journal
- DOI
10.1093/gerona/glae010