Malnutrition and Malnutrition Risk Can Be Associated with Systolic Orthostatic Hypotension in Older Adults
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.
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).
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).
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 wordsMalnutrition malnutrition-risk orthostatic hypotension
- 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
- 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.CrossRefPubMedPubMedCentralGoogle Scholar
- 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.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
- 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
- 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.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