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Autonomic dysfunction in dementia
L M Allan1, C G Ballard, J Allen
1Institute for Ageing and Health, Wolfson Research Centre, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK. louise.allan@ncl.ac.uk
Journal of Neurology, Neurosurgery, and Psychiatry
|December 21, 2006
Summary
Cardiovascular autonomic dysfunction is present in all common dementias, particularly Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), impacting treatment strategies.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- No prior studies compared autonomic function across Alzheimer's disease (AD), vascular dementia (VAD), dementia with Lewy bodies (DLB), and Parkinson's disease dementia (PDD).
- Autonomic dysfunction is a potential comorbidity in neurodegenerative diseases.
Purpose of the Study:
- To compare cardiovascular autonomic function in patients with AD, VAD, DLB, and PDD against elderly controls.
- To determine the prevalence of orthostatic hypotension and autonomic neuropathies using established classifications.
Main Methods:
- Utilized Ewing's battery of autonomic function tests and power spectral analysis of heart rate variability.
- Assessed 39 AD, 30 VAD, 30 DLB, 40 PDD patients, and 38 elderly controls.
Main Results:
- Significant differences in autonomic dysfunction severity were observed across dementia types.
- Parkinson's disease dementia (PDD) and DLB exhibited considerable autonomic dysfunction, with PDD showing more severe impairment than DLB.
- Alzheimer's disease (AD) showed minimal autonomic impairment, primarily orthostatic hypotension, while VAD had limited dysfunction.
Conclusions:
- Autonomic dysfunction is prevalent in all common dementias, notably PDD and DLB.
- The degree of autonomic dysfunction varies significantly between dementia subtypes.
- Findings have implications for clinical management and treatment of patients with dementia.
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