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The journal of nutrition, health & aging

, Volume 22, Issue 8, pp 928–933 | Cite as

Malnutrition and Malnutrition Risk Can Be Associated with Systolic Orthostatic Hypotension in Older Adults

  • S. E. Kocyigit
  • P. Soysal
  • E. Ates Bulut
  • A. T. Isik
Article

Abstract

Background

Malnutrition and orthostatic hypotension(OH) are the two important geriatric syndromes, which have similar negative outcomes such as falls. The aim of the study is to detect whether there is any relation between malnutrition and OH.

Methods

862 geriatric patients, who had undergone comprehensive geriatric assessment (CGA),were included in the retrospective study. OH was identified as 20 and/or 10 mmHg dropped for systolic and/or diastolic blood pressures with the active standing test when patients got up from supine to standing position. Nutritional status was checked according to Mini Nutritional Assesment-Short Form(MNASF).

Results

The mean age of the patients was 74±8.05, and %66.3 of them were female. The prevalence of malnutrition, malnutrition-risk and OH were detected as 7.7%, 26.9 % and 21.2%, respectively. When OH, systolic OH, diastolic OH and control group were compared with CGA parameters and the effects of age and gender were removed, the frequency of falls and Timed-Up and Go Test were higher, activity daily living indexes and TINETTI-Balance scores were lower in systolic OH than without it (p<0.05). Systolic OH was more frequent in malnutrition-risk and malnutrition group than control group (p<0.002 and p<0.05, respectively). Diastolic OH was not associated with nutritional status (p>0.05).OH was only higher in malnutrition-risk group than robust (p<0.05).

Conclusion

Our findings suggest that not only malnutrition but also malnutrition-risk may be associated with systolic OH, which leads to many negative outcomes in older adults. Because malnutrition/malnutrition risk is preventable and reversible, nutritional status should be checked during the evaluation of OH patients.

Key words

Malnutrition malnutrition-risk orthostatic hypotension 

References

  1. 1.
    Johnson LE, & Sullivan DH. Malnutrition in Older Adults.Brocklehurst’s Textbook of Geriatric Medicine and Gerontology (Eight Edition)2016. Philadelphia: Elsevier,(Chapter 109;pp:914–922).Google Scholar
  2. 2.
    Söderström L, Rosenblad A, Adolfsson ET, Bergkvist L. Malnutrition is associated with increased mortality in older adults regardless of the cause of death. Br J Nutr 2017;117(4): 532–540.CrossRefPubMedGoogle Scholar
  3. 3.
    Damião R, Santos Á, Matijasevich A, Menezes P. Factors associated with risk of malnutrition in the elderly in south-eastern Brazil. Rev Bras Epidemiol 2017; 20(4):598–610.CrossRefPubMedGoogle Scholar
  4. 4.
    Kvamme J, Grønli O, Florholmen J, Jacobsen B. Risk of malnutrition is associated with mental health symptoms in community living elderly men and women: The Tromsø Study. BMC Psychiatry 2011; 11: 112.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gomes F, Emery P, Weekes C. Risk of Malnutrition Is an Independent Predictor of Mortality, Length of Hospital Stay, and Hospitalization Costs in Stroke Patients. J Stroke Cerebrovasc Dis 2016; 25(4):799–806.CrossRefPubMedGoogle Scholar
  6. 6.
    Yoshimura K., Yamada M, Kajiwara Y, Nishiguchi S, Aoyama T. Relationship between depression and risk of malnutrition among community-dwelling young-old and old-old elderly people. Aging Ment Health 2013;17(4):456–60.CrossRefPubMedGoogle Scholar
  7. 7.
    Visvanathan R, Newbury J, Chapman I. Malnutrition in older people—screening and management strategies. Aust Fam Physician 2004; 33(10): 799–805.PubMedGoogle Scholar
  8. 8.
    Guyonnet S, Rolland Y. Screening for Malnutrition in Older People. Clin Geriatr Med 2015;31(3):429–37.CrossRefPubMedGoogle Scholar
  9. 9.
    Angelousi A, Girerd N, Benetos A, Frimat L, Gautier S, Weryha G, Boivin J. Association between orthostatic hypotension and cardiovascular risk, cerebrovascular risk, cognitive decline and falls as well as overall mortality: a systematic review and meta-analysis. J Hypertens 2014; 32(8):1562–71.CrossRefPubMedGoogle Scholar
  10. 10.
    Ooi W, Hossain M, Lipsitz L. The association between orthostatic hypotension and recurrent falls in nursing home residents. Am J Med 2000;108(2):106–11.CrossRefPubMedGoogle Scholar
  11. 11.
    McHugh J, Fan C, Kenny R, Lawlor B. Orthostatic hypotension and subjective sleep quality in older people. Aging Ment Health 2012; 16(8): 958–63.CrossRefPubMedGoogle Scholar
  12. 12.
    Romero-ortuno R, Cogan L, Foran T, Kenny RA, Fan CW. Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people. J Am Geriatr Soc 2011;59(4): 655–65.CrossRefPubMedGoogle Scholar
  13. 13.
    McCarroll K, Robinson D, Coughlan A, Healy M, Kenny R, Cunningham C. Vitamin D and orthostatic hypotension. Age Ageing 2012; 41(6): 810–3.CrossRefPubMedGoogle Scholar
  14. 14.
    Moore A, Ryan J, Watts M, Pillay I, Clinch D, Lyons D. Orthostatic tolerance in older patients with vitamin B12 deficiency before and after vitamin B12 replacement. Clin Auton Res 2004; 14(2): 67–71.CrossRefPubMedGoogle Scholar
  15. 15.
    Fedorowski A, Wahlstrand B, Hedner T, Melander O. Systolic and diastolic component of orthostatic hypotension and cardiovascular events in hypertensive patients: the Captopril Prevention Project. J Hypertens 2014;32(1):75–81.CrossRefPubMedGoogle Scholar
  16. 16.
    Soysal P, Isik A, Buyukaydin B, Kazancioglu, R. A comparison of end-stage renal disease and Alzheimer’s disease in the elderly through a comprehensive geriatric assessment. International Urology and Nephrology 2014; 46(8): 1627–32.CrossRefPubMedGoogle Scholar
  17. 17.
    The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 1999;46(5):170.Google Scholar
  18. 18.
    Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony PS, Charlton KE, Maggio M, Tsai AC, Vellas B, Sieber CC; Mini Nutritional Assessment International Group. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58(9): 1734–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Burks CE, Jones CW, Braz VA, Swor RA, Richmond NL, Hwang KS, Hollowell AG, Weaver MA, Platts-Mills TF. Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study. J Am Geriatr Soc 2017;65(8):1741–1747.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Snider JT, Linthicum MT, Wu Y, LaVallee C, Lakdawalla DN, Hegazi R, Matarese L. Economic burden of communitybased disease-associated malnutrition in the United States.. JPEN J Parenter Enteral Nutr 2014;38(2 Suppl):77S–85S.CrossRefPubMedGoogle Scholar
  21. 21.
    Schrader E, Grosch E, Bertsch T, Sieber C, Volkert, D. Nutritional and Functional Status in Geriatric Day Hospital Patients - MNA Short Form Versus Full MNA. J Nutr Health Aging 2016; 20(9):918–926.CrossRefPubMedGoogle Scholar
  22. 22.
    Low PA, Opfer-Gehrking TL, McPhee BR, Fealey RD, Benarroch EE, Willner CL, Suarez GA, Proper CJ, Felten JA, Huck CA, et al. Prospective evaluation of clinical characteristics of orthostatic hypotension. Mayo Clin Proc 1995;70(7):617–22.CrossRefPubMedGoogle Scholar
  23. 23.
    Soysal P, Yay A, Isik AT. Does vitamin D deficiency increase orthostatic hypotension risk in the elderly patients ? Arch Gerontol Geriatr 2014; 59(1): 74–77.CrossRefPubMedGoogle Scholar
  24. 24.
    Soysal P, Aydin AE, Koc Okudur S, Isik AT. When should orthostatic blood pressure changes be evaluated in elderly: 1st, 3rd or 5th minute? Arch Gerontol Geriatr 2016;65:199–203.CrossRefPubMedGoogle Scholar
  25. 25.
    Finucane C, O’Connell M, Donoghue O, Richardson K., Savva G, Kenny R. Impaired Orthostatic Blood Pressure Recovery Is Associated with Unexplained and Injurious Falls. J Am Geriatr Soc 2017; 65(3):474–482.CrossRefPubMedGoogle Scholar
  26. 26.
    Curreri C, Giantin V, Veronese N, Trevisan C, Sartori L, Musacchio E, Zambon S, Maggi S, Perissinotto E, Corti MC, Crepaldi G, Manzato E, Sergi G. (2016). Orthostatic Changes in Blood Pressure and Cognitive Status in the Elderly: The Progetto Veneto Anziani Study. Hypertension 2016; 68(2): 427–35.CrossRefPubMedGoogle Scholar
  27. 27.
    Roy M, Gaudreau P, Payette H. A scoping review of anorexia of aging correlates and their relevance to population health interventions. Appetite 2016;105:688–699.CrossRefPubMedGoogle Scholar
  28. 28.
    Frith J, Parry SW. New Horizons in orthostatic hypotension. Age Ageing 2017;46(2): 168–174.CrossRefPubMedGoogle Scholar
  29. 29.
    Luukinen H, Koski K, Laippala P, Kivelä SL. Prognosis of diastolic and systolic orthostatic hypotension in older persons. Arch Intern Med. 1999;159(3):273–80.CrossRefPubMedGoogle Scholar
  30. 30.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M; European Working Group on Sarcopenia in Older People. (2010). Sarcopenia: European consensus on definition and diagnosis Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39(4):412–423.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Reijnierse EM, Trappenburg MC, Leter MJ, Blauw GJ, de van der Schueren MA, Meskers CG, Maier AB. The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients. PLoS One 2015; 10(8):e0135933. doi:  https://doi.org/10.1371/journal.pone.0135933.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Luukkonen A, Tiihonen M, Rissanen T, Hartikainen S, Nykänen I. Orthostatic Hypotension and Associated Factors among Home Care Clients Aged 75 Years or Older - A Population-Based Study. J Nutr Health Aging 2018; 22(1):154–158.CrossRefPubMedGoogle Scholar
  33. 33.
    Aydin AE, Soysal P, Isik AT. Which is preferable for orthostatic hypotension diagnosis in older adults: active standing test or head-up tilt table test? Clin Interv Aging 2017; 12: 207–212.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • S. E. Kocyigit
    • 1
  • P. Soysal
    • 2
  • E. Ates Bulut
    • 1
  • A. T. Isik
    • 1
    • 3
  1. 1.Dokuz Eylul University, Faculty of Medicine, Department of Geriatric MedicineIzmirTurkey
  2. 2.Geriatric CenterKayseri Education and Research HospitalKayseriTurkey
  3. 3.Center for Aging Brain and DementiaDokuz Eylul University, Faculty of MedicineIzmirTurkey

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