The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia
Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in...
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| Veröffentlicht in: | PloS one 2012-10, Vol.7 (10), p.e45451-e45451 |
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| description | Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival.
Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline.
There was a high frequency of persistent orthostatic blood pressure (50%), constipation (30%) and incontinence (30%). Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2) = 4.47, p = 0.034). Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2) = 6.370, p = 0.041).
According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to avoid falls and other complications, but also as a possible predictor of survival. |
| doi_str_mv | 10.1371/journal.pone.0045451 |
| format | Article |
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Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline.
There was a high frequency of persistent orthostatic blood pressure (50%), constipation (30%) and incontinence (30%). Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2) = 4.47, p = 0.034). Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2) = 6.370, p = 0.041).
According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to avoid falls and other complications, but also as a possible predictor of survival.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0045451</identifier><identifier>PMID: 23049679</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Alzheimer's disease ; Analysis ; Autonomic nervous system ; Autonomic Nervous System Diseases - complications ; Blood ; Blood pressure ; Care and treatment ; Clinical Medicine ; Cognitive ability ; Complications ; Constipation ; Constipation - etiology ; Constipation - physiopathology ; Dementia ; Dementia disorders ; Disease Progression ; Drug dosages ; Dysautonomia ; Follow-Up Studies ; Geriatrics ; Humans ; Hypotension ; Kaplan-Meier Estimate ; Klinisk medicin ; Lewy bodies ; Lewy Body Disease - complications ; Longitudinal Studies ; Medical and Health Sciences ; Medical prognosis ; Medicin och hälsovetenskap ; Medicine ; Memory ; Movement disorders ; Neurodegenerative diseases ; Neurologi ; Neurology ; Neurosciences ; Parkinson Disease - complications ; Parkinson's disease ; Patient outcomes ; Patients ; Population ; Prospective Studies ; Psychiatry ; Shy-Drager Syndrome - etiology ; Shy-Drager Syndrome - physiopathology ; Studies ; Supranuclear Palsy, Progressive - complications ; Survival ; Urinary incontinence ; Urinary Incontinence - etiology ; Urinary Incontinence - physiopathology</subject><ispartof>PloS one, 2012-10, Vol.7 (10), p.e45451-e45451</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>Stubendorff et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2012 Stubendorff et al 2012 Stubendorff et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-10c10e77a93ff7f0e0c13a191da55f3c0c5e33efd8414e2fdade07c5b72ee97b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462171/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462171/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23049679$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/3160909$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:125410132$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Stubendorff, Kajsa</creatorcontrib><creatorcontrib>Aarsland, Dag</creatorcontrib><creatorcontrib>Minthon, Lennart</creatorcontrib><creatorcontrib>Londos, Elisabet</creatorcontrib><title>The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival.
Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline.
There was a high frequency of persistent orthostatic blood pressure (50%), constipation (30%) and incontinence (30%). Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2) = 4.47, p = 0.034). Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2) = 6.370, p = 0.041).
According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to avoid falls and other complications, but also as a possible predictor of survival.</description><subject>Alzheimer's disease</subject><subject>Analysis</subject><subject>Autonomic nervous system</subject><subject>Autonomic Nervous System Diseases - complications</subject><subject>Blood</subject><subject>Blood pressure</subject><subject>Care and treatment</subject><subject>Clinical Medicine</subject><subject>Cognitive ability</subject><subject>Complications</subject><subject>Constipation</subject><subject>Constipation - etiology</subject><subject>Constipation - physiopathology</subject><subject>Dementia</subject><subject>Dementia disorders</subject><subject>Disease Progression</subject><subject>Drug dosages</subject><subject>Dysautonomia</subject><subject>Follow-Up Studies</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Kaplan-Meier Estimate</subject><subject>Klinisk medicin</subject><subject>Lewy bodies</subject><subject>Lewy Body Disease - complications</subject><subject>Longitudinal Studies</subject><subject>Medical and Health Sciences</subject><subject>Medical prognosis</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>Memory</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neurologi</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson's disease</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Population</subject><subject>Prospective Studies</subject><subject>Psychiatry</subject><subject>Shy-Drager Syndrome - etiology</subject><subject>Shy-Drager Syndrome - physiopathology</subject><subject>Studies</subject><subject>Supranuclear Palsy, Progressive - complications</subject><subject>Survival</subject><subject>Urinary incontinence</subject><subject>Urinary Incontinence - etiology</subject><subject>Urinary Incontinence - 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The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival.
Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline.
There was a high frequency of persistent orthostatic blood pressure (50%), constipation (30%) and incontinence (30%). Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2) = 4.47, p = 0.034). Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2) = 6.370, p = 0.041).
According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to avoid falls and other complications, but also as a possible predictor of survival.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23049679</pmid><doi>10.1371/journal.pone.0045451</doi><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1344508729 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; SWEPUB Freely available online; Free Full-Text Journals in Chemistry |
| subjects | Alzheimer's disease Analysis Autonomic nervous system Autonomic Nervous System Diseases - complications Blood Blood pressure Care and treatment Clinical Medicine Cognitive ability Complications Constipation Constipation - etiology Constipation - physiopathology Dementia Dementia disorders Disease Progression Drug dosages Dysautonomia Follow-Up Studies Geriatrics Humans Hypotension Kaplan-Meier Estimate Klinisk medicin Lewy bodies Lewy Body Disease - complications Longitudinal Studies Medical and Health Sciences Medical prognosis Medicin och hälsovetenskap Medicine Memory Movement disorders Neurodegenerative diseases Neurologi Neurology Neurosciences Parkinson Disease - complications Parkinson's disease Patient outcomes Patients Population Prospective Studies Psychiatry Shy-Drager Syndrome - etiology Shy-Drager Syndrome - physiopathology Studies Supranuclear Palsy, Progressive - complications Survival Urinary incontinence Urinary Incontinence - etiology Urinary Incontinence - physiopathology |
| title | The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T17%3A10%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20impact%20of%20autonomic%20dysfunction%20on%20survival%20in%20patients%20with%20dementia%20with%20Lewy%20bodies%20and%20Parkinson's%20disease%20with%20dementia&rft.jtitle=PloS%20one&rft.au=Stubendorff,%20Kajsa&rft.date=2012-10-01&rft.volume=7&rft.issue=10&rft.spage=e45451&rft.epage=e45451&rft.pages=e45451-e45451&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0045451&rft_dat=%3Cgale_plos_%3EA543319630%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1344508729&rft_id=info:pmid/23049679&rft_galeid=A543319630&rft_doaj_id=oai_doaj_org_article_595499a38b6048bd9436133e57cf5c92&rfr_iscdi=true |