Skip to main content
Log in

Orthostatic reactions in the 85- year olds

  • Original Articles
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Testing of the orthostatic reaction is recommended in the examination of elderly fallers. This test usually includes blood pressure and instantaneous heart rate measurement but is difficult to perform in very elderly people according to the guidelines suggested for younger subjects. One reason for this is that old people often stand up slowly. The use of a tilt table, which enables a rapid change in posture from recumbent to erect position, is tempting as it could provide a method for a better standardized test. To study the usefulness of the tilt table as well as the degree of orthostatic reaction in the very elderly, we examined a sample of 85- year olds who did not suffer from falls. All were tested both with the tilt table and with active rising. The drop in blood pressure was equal in the two test types, but the increase in heart rate was significantly larger in active rising. Many test subjects were afraid of the tilt table, and two developed cardiac arrythmia, i.e., atrial fibrillation, during the test. In our opinion, active rising is the method of choice in old persons. While the test subjects were in unusually good health for their age and thus could provide a suitable reference group for this test, the systolic blood pressure dropped considerably in several during the test. Criteria and indexes developed for younger subjects are not useful, and different evaluation criteria should be developed for the very elderly. (Aging Clin. Exp. Res. 4: 139- 144, 1992)

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Rubenstein L.Z., Robbins A.S.: Falls in elderly. A clinical perspective. Geriatrics 4: 67–78, 1984.

    Google Scholar 

  2. Mattila K., Haavisto M., Rajala S.: Body mass index and mortality in the elderly. Br. Med. J. 292: 867–868, 1986.

    Article  CAS  Google Scholar 

  3. Tideiksaar R., Kay A.D.: Explaining falls: a logical procedure. Geriatr. Med. 8: 25–30, 1987.

    Google Scholar 

  4. Collins K.J., Exton-Smith A.N., James M.H., Oliver D.J.: Functional changes in autonomic nervous responses with ageing. Age Ageing 9: 17–24, 1980.

    Article  PubMed  CAS  Google Scholar 

  5. Ewing D.J., Campbell I.W., Murray A., Neilson J.M.M., Clarke B.F.: Immediate heart-rate response to standing: simple test for autonomic neuropathy in diabetes. Br. Med. J. 1: 145–147, 1978.

    Article  PubMed  CAS  Google Scholar 

  6. Thulesius O.: Pathophysiological classification and diagnosis of orthostatic hypotension. Cardiology 61 (Suppl. 1): 180–190, 1976.

    Article  PubMed  Google Scholar 

  7. Ewing D.J.: Cardiovascular reflexes and autonomic neuropathy. Clin. Sci. Mol. Med. 55: 321–327, 1978.

    PubMed  CAS  Google Scholar 

  8. Maisey D.M.: Tests of autonomie function. Lancet 1: 46, 1981.

    Article  PubMed  CAS  Google Scholar 

  9. Wieling W., van Brederode J.F.M., de Rijk L.G., Borst C., Dunning A.J.: Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy. Diabetologia 22: 163–166, 1982.

    Article  PubMed  CAS  Google Scholar 

  10. Caird F.I., Abdrews G.R., Kennedy R.D.: Effect of posture in the elderly. Br. Heart J. 35: 527–530, 1973.

    Article  PubMed  CAS  Google Scholar 

  11. Ewing D.J., Hume L, Campbell I.W., Murray A., Neilson J.M.M., Clarke B.F.: Autonomie mechanisms in the initial heart rate response to standing. J. Appl. Physiol. 49: 809–814, 1980.

    PubMed  CAS  Google Scholar 

  12. Borst C., van Brederode J.F.M., Wieling W., van Montfrans G.A., Dunning A.J.: Mechanisms of initial blood pressure response to postural change. Clin. Sci. 67: 321–327, 1984.

    PubMed  CAS  Google Scholar 

  13. Stålberg E.V., Nogués M.A.: Automatic analysis of heart rate variation. I. Method and reference values in healthy controls. Muscle Nerve 12: 993–1000, 1989.

    Article  PubMed  Google Scholar 

  14. Robinson B.J., Stowell L.I., Johnson R.H., Palmer K.T.: Is orthostatic hypotension in the elderly due to autonomie failure? Age Ageing 19: 288–296, 1990.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jäntti, P. Orthostatic reactions in the 85- year olds. Aging Clin Exp Res 4, 139–144 (1992). https://doi.org/10.1007/BF03324083

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03324083

Keywords

Navigation