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Orthostatic blood pressure changes and physical, functional and cognitive performance: the MELoR study
Nor Izzati Saedon1,2, James Frith3, Choon-Hian Goh4,5
1Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. izzati@ummc.edu.my.
Summary
Initial orthostatic hypotension (IOH) and classical orthostatic hypotension (COH) in older adults are linked to better physical and cognitive performance, challenging previous assumptions about frailty.
Area of Science:
- Gerontology
- Cardiovascular Physiology
- Neurology
Background:
- Orthostatic hypotension (OH) definitions, including initial (IOH) and classical (COH), lack clear clinical relevance in older adults.
- Understanding postural blood pressure changes is crucial for assessing health in aging populations.
Purpose of the Study:
- To investigate factors influencing postural blood pressure changes in older adults.
- To determine the relationship between postural blood pressure changes and physical, functional, and cognitive performance.
Main Methods:
- Recruited 1245 individuals aged ≥55 years from the Malaysian Elders Longitudinal Research (MELoR) study.
- Monitored continuous non-invasive blood pressure (BP) during supine rest and standing.
- Assessed physical performance (timed-up-and-go, functional reach, handgrip, Lawton's scale) and cognition (Montreal Cognitive Assessment).
Main Results:
- Participants were categorized into no OH, COH, IOH, and COH + IOH groups.
- Multivariate analyses showed better physical performance in IOH compared to no OH.
- COH + IOH group demonstrated better physical and cognitive performance than the no OH group; COH group showed better cognition than no OH.
Conclusions:
- Older adults meeting IOH criteria exhibited enhanced physical and cognitive performance.
- An initial postural blood pressure drop (IOH) in individuals aged ≥55 may not correlate with increased frailty.
- Findings suggest current OH definitions may not accurately reflect frailty in older adults.
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