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Related Experiment Videos

Autonomic dysfunction in elderly bedfast patients.

M Kihara1, M Takahashi, K Nishimoto

  • 1Department of Neurology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589, Japan.

Age and Ageing
|April 5, 2003
PubMed
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Bed rest impairs autonomic function, particularly sympathetic responses in the lower extremities, in elderly patients. Orthostatic hypotension is linked to beta-adrenergic dysfunction, highlighting the importance of mobility for autonomic health.

Area of Science:

  • Gerontology
  • Autonomic Neuroscience
  • Cardiovascular Physiology

Background:

  • Bed confinement in elderly individuals can lead to significant physiological deconditioning.
  • Autonomic nervous system (ANS) dysfunction is a common complication in sedentary or bedridden populations.
  • Orthostatic hypotension (OH) is a prevalent issue in the elderly, impacting cardiovascular regulation.

Purpose of the Study:

  • To quantitatively assess autonomic nervous system function in elderly patients who are bedfast.
  • To differentiate autonomic responses between bedfast patients with and without orthostatic hypotension (OH).
  • To investigate the impact of immobility on specific components of autonomic function.

Main Methods:

  • Evaluated orthostatic blood pressure and heart rate responses to tilt and deep breathing.

Related Experiment Videos

  • Utilized the quantitative sudomotor axon reflex test (QSART) to assess sympathetic sudomotor function.
  • Measured beat-to-beat blood pressure during phases II and IV of the Valsalva maneuver (VM).
  • Compared 15 bedfast patients (OH+ and OH-) with 12 age-matched controls.

    • Main Results:

    • All bedfast patients exhibited impaired late phase II beat-to-beat blood pressure response.
    • Patients with orthostatic hypotension (OH+) showed an additional abnormality in phase IV of the Valsalva maneuver.
    • Reduced QSART responses in the distal leg and foot were observed in both OH+ and OH- groups.
    • No significant differences were found in the duration of being bedfast or activities of daily living between OH+ and OH- groups.

    Conclusions:

    • Prolonged bed rest leads to postganglionic sympathetic dysfunction in the lower extremities.
    • Beta-adrenergic dysfunction is associated with orthostatic hypotension in some bedfast elderly patients.
    • Maintaining mobility is crucial for preserving normal autonomic functions in the elderly population.