TY - JOUR
T1 - Orthostatic Hypotension and Orthostatic Intolerance Symptoms in Geriatric Rehabilitation Inpatients, RESORT
AU - Christopoulos, Elena M.
AU - Reijnierse, Esmee M.
AU - Lange, Peter W.
AU - Meskers, Carel G. M.
AU - Maier, Andrea B.
N1 - Funding Information: This research was funded by an unrestricted grant of the University of Melbourne (Australia) received by Professor Andrea B. Maier and the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH), Australia. Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Objectives: Orthostatic hypotension (OH) and orthostatic intolerance symptoms are common in older community-dwelling adults and are associated with reduced quality of life and detrimental health outcomes. This study aimed to determine the prevalence, co-occurrence and determinants of OH and orthostatic intolerance symptoms in geriatric rehabilitation inpatients. Design: Observational, longitudinal cohort, “REStORing the health of acutely unwell adulTs” (RESORT). Setting and Participants: Geriatric rehabilitation inpatients (n = 1505) of a tertiary teaching hospital in Melbourne, Australia. Methods: OH was defined as a drop in systolic blood pressure by ≥20 mm Hg and/or diastolic blood pressure by ≥10 mm Hg within three 3 of moving from supine to a standing or sitting position. Symptoms were recorded following the 3 minutes. Determinants included sociodemographics, reason for admission, cognitive health, nutritional status, physical performance, frailty, morbidity, medication use, length of stay (LOS), and number of geriatric conditions. Independent t-tests, Mann-Whitney U tests or χ2 tests were used to analyze differences between inpatients with and without OH and symptoms. Logistic regression analyses were used to ascertain the determinants. Results: OH and orthostatic intolerance symptoms were prevalent in 19.8% (standing: 21.4%, sitting: 18.2%) and 22.6% (standing: 25.0%, sitting: 20.2%) of inpatients, respectively. Symptoms were reported by 32.8% of inpatients with OH and 20.1% without OH. Higher number of comorbidities and geriatric conditions, low functional independence, and longer LOS were determinants of OH. Female gender, higher number of morbidities and geriatric conditions, low functional independence, depression risk, poor physical performance, musculoskeletal and “other” reasons for admission, and long LOS during geriatric rehabilitation were determinants of symptoms. Conclusions and Implications: OH and orthostatic intolerance symptoms occur in one-fifth of geriatric rehabilitation inpatients, however, the co-occurrence is low and determinants differ. Poorer health in patients with orthostatic intolerance symptoms highlights the need to assess symptoms in clinical practice, independent of an OH diagnosis.
AB - Objectives: Orthostatic hypotension (OH) and orthostatic intolerance symptoms are common in older community-dwelling adults and are associated with reduced quality of life and detrimental health outcomes. This study aimed to determine the prevalence, co-occurrence and determinants of OH and orthostatic intolerance symptoms in geriatric rehabilitation inpatients. Design: Observational, longitudinal cohort, “REStORing the health of acutely unwell adulTs” (RESORT). Setting and Participants: Geriatric rehabilitation inpatients (n = 1505) of a tertiary teaching hospital in Melbourne, Australia. Methods: OH was defined as a drop in systolic blood pressure by ≥20 mm Hg and/or diastolic blood pressure by ≥10 mm Hg within three 3 of moving from supine to a standing or sitting position. Symptoms were recorded following the 3 minutes. Determinants included sociodemographics, reason for admission, cognitive health, nutritional status, physical performance, frailty, morbidity, medication use, length of stay (LOS), and number of geriatric conditions. Independent t-tests, Mann-Whitney U tests or χ2 tests were used to analyze differences between inpatients with and without OH and symptoms. Logistic regression analyses were used to ascertain the determinants. Results: OH and orthostatic intolerance symptoms were prevalent in 19.8% (standing: 21.4%, sitting: 18.2%) and 22.6% (standing: 25.0%, sitting: 20.2%) of inpatients, respectively. Symptoms were reported by 32.8% of inpatients with OH and 20.1% without OH. Higher number of comorbidities and geriatric conditions, low functional independence, and longer LOS were determinants of OH. Female gender, higher number of morbidities and geriatric conditions, low functional independence, depression risk, poor physical performance, musculoskeletal and “other” reasons for admission, and long LOS during geriatric rehabilitation were determinants of symptoms. Conclusions and Implications: OH and orthostatic intolerance symptoms occur in one-fifth of geriatric rehabilitation inpatients, however, the co-occurrence is low and determinants differ. Poorer health in patients with orthostatic intolerance symptoms highlights the need to assess symptoms in clinical practice, independent of an OH diagnosis.
KW - Hypotension
KW - aged
KW - blood pressure
KW - orthostatic intolerance
KW - rehabilitation
KW - symptoms
UR - http://www.scopus.com/inward/record.url?scp=85114269480&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jamda.2021.08.014
DO - https://doi.org/10.1016/j.jamda.2021.08.014
M3 - Article
C2 - 34478695
SN - 1525-8610
VL - 22
SP - 2468-2477.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 12
ER -