Orthostatic intolerance: a frailty marker for older adults

Key summary points Aim We aim to investigate the association between frailty and orthostatic intolerance syndrome (OIS) with or without orthostatic blood pressure changes (OBPC). Findings Our results show that OIS, both self-reported and provoked during the test, is strongly associated with frailty. Message This study shows that OIS is an important marker for clinical reflection of frailty. Purpose Frailty, orthostatic blood pressure changes (OBPC), and orthostatic intolerance syndrome (OIS) are common in geriatric patients. However, the results of the studies evaluating the relationship between these entities are discordant. We aimed to investigate the association between frailty and OIS with or without OBPC. Methods Comprehensive geriatric assessment (CGA), frailty assessment, OBPC evaluations in the active-standing test (1st, 3rd, 5th, and 10th min), OIS investigation both in history before the test (self-reported OIS) and emerged during the active-standing test, and sarcopenia assessment via BIA and handgrip strength (HGS) were performed in 102 geriatric outpatients. Results Patients were divided into three categories according to their frailty status (non-frail, prefrail, and frail) by Modified Fried Frailty Index (FFI) and Clinical Frailty Scale (CFS). Prevalence of self-reported OIS and OIS during the test were statistically higher in the frail group assessed by both frailty scales ( P value: 0.001 for CFS, P value