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

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.

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.

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.

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.