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Orthostatic hypotension in dementia with Lewy bodies: a meta-analysis of prospective studies

Clinical Autonomic Research (2023)Cite this article

Abstract

Purpose

Orthostatic hypotension (OH), one of the supportive clinical features in the diagnosis of dementia with Lewy bodies (DLB), is a significant problem in advanced age because of its severe negative consequences. The aim of this meta-analysis was to investigate the prevalence and risk of OH in patients with DLB.

Methods

The indexes and databases cited to identify relevant studies were PubMed, ScienceDirect, Cochrane, and Web of Science. The keywords for the search were “Lewy body dementia” and “autonomic dysfunction” or “dysautonomia” or “postural hypotension” or “orthostatic hypotension.” English-language articles published from January 1990 to April 2022 were searched. The Newcastle–Ottawa scale was applied to evaluate the quality of the studies. 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 patients with DLB was also combined using the random effects model.

Results

Eighteen studies (10 case controls and 8 case series) were included to evaluate the prevalence of OH in patients with DLB. Higher rates of OH were found to be associated with DLB (OR 7.71, 95% CI 4.42, 13.44; p < 0.001), and 50.8% of 662 patients had OH.

Conclusion

DLB increased the risk of OH by 3.62- to 7.71-fold compared to healthy controls. Therefore, it will be useful to evaluate postural blood pressure changes in the follow-up and treatment of patients with DLB.

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Authors and Affiliations

  1. Unit for Aging Brain and Dementia, Department of Geriatric Medicine, School of Medicine, Faculty of Medicine, Dokuz Eylul University, Balcova, 35340, Izmir, Turkey

    Ahmet Turan Isik, Mehmet Selman Ontan & Derya Kaya

  2. Department of Geriatric Medicine, Darica State Hospital, Kocaeli, Turkey

    Fatma Sena Dost

  3. Department of Statistics, Faculty of Science, Dokuz Eylul University, Izmir, Turkey

    Idil Yavuz

  4. Department of Geriatric Medicine, Adana State Hospital, Adana, Turkey

    Esra Ates Bulut

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  1. Ahmet Turan Isik
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  2. Fatma Sena Dost
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Isik, A.T., Dost, F.S., Yavuz, I. et al. Orthostatic hypotension in dementia with Lewy bodies: a meta-analysis of prospective studies. Clin Auton Res (2023). https://doi.org/10.1007/s10286-023-00933-1

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  • DOI: https://doi.org/10.1007/s10286-023-00933-1

Keywords

  • Orthostatic hypotension
  • Dementia with Lewy bodies
  • Autonomic dysfunction
  • Head-up tilt table test
  • Active standing test