What is the relationship between frailty and orthostatic hypotension in older adults?

Suleyman Emre Kocyigit; Pinar Soysal; Esra Ates Bulut; Ali Ekrem Aydin; Ozge Dokuzlar; Ahmet Turan Isik

doi:10.11909/j.issn.1671-5411.2019.03.005

What is the relationship between frailty and orthostatic hypotension in older adults?

J Geriatr Cardiol. 2019 Mar;16(3):272-279. doi: 10.11909/j.issn.1671-5411.2019.03.005.

Authors

Suleyman Emre Kocyigit¹, Pinar Soysal², Esra Ates Bulut¹, Ali Ekrem Aydin¹, Ozge Dokuzlar¹, Ahmet Turan Isik¹

Affiliations

¹ Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
² Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.

PMID: 31080470
PMCID: PMC6500562
DOI: 10.11909/j.issn.1671-5411.2019.03.005

Abstract

Background: Frailty and orthostatic hypotension (OH), which is common in older adults, is associated with morbidity and mortality. The relationship between them remains unclear. The aim of the study is to determine whether there is a relationship between frailty and OH.

Methods: A total of 496 patients who were admitted to the geriatric clinic and underwent comprehensive geriatric assessment were retrospectively reviewed. In a cross-sectional and observational study, OH was measured by the Head-up Tilt Table test at 1, 3, and 5 min (respectively, OH₁, OH_3, and OH₅) and the frailty was measured by the Fried's frailty scale.

Results: The mean age of all patients was 75.4 ± 7.38. The prevalence of females was 69.8%. When the frail people were compared with the pre-frail and the robust ones, the frailty was associated with OH₁. There was no relationship between the groups in terms of OH₁ when the pre-frail group was compared with the robust group. OH₃ were higher in the frail group than in the pre-frail group (P < 0.05) and the OH₅ were higher in the frail group than in the pre-frail and robust group (P < 0.05), but OH₃ and OH₅ were not associated with frailty status when they were adjusted for age (P > 0.05). Slowness and weakness were associated with OH₁ (P < 0.05), whereas the other components of the Fried's test were not.

Conclusions: Frailty may be a risk factor for OH₁. The 1^st min measurements of OH should be routinely evaluated in frail older adults to prevent OH-related poor outcomes.

Keywords: Frail; Orthostatic hypotension; Pre-frail; Robust.