Objective: To determine the prevalence of OH and its associations with autonomic dysfunction, falls, and mortality.

Background: Orthostatic hypotension (OH) is a common problem that peaks among older adults, residents of nursing homes, and patients with neurodegenerative diseases [1]. Determining the prevalence of OH and its associated comorbidities will enhance the quality of life and prognosis for this patient cohort.

Method: Over a period of 2 years, we examined 181 patients residing in a nursing home. For this study, we utilized the following assessments:

· Orthostatic Hypotension Questionnaire – OH Symptom Assessment (OHSA) [2]

· COMPASS-31 [3]

· The Edmonton Frail Scale

· Montreal Cognitive Assessment (MoCA)

· Diagnosis of OH was established using the standard orthostatic test.

Results: In our study, patients with OH were categorized into four groups based on four primary diagnoses: Alzheimer’s disease, Parkinson’s disease, small vessel disease, and chronic stage ischemic stroke. Statistical analysis revealed a prevalence of OH of 37%. The overall characteristics of patients with OH are presented in Table 1.

We found that patients who died during the follow-up period had a higher level of autonomic dysfunction confirmed by the COMPASS-31 assessment (p < 0.001) (Figure 1).

We also determined the frequency of falls and falls leading to hip fractures among patients across all four groups. The highest incidence was observed in the Alzheimer’s disease group (Figure 2).

In a concluding phase, we assessed the survival rates of patients with OH (Figure 3) and analyzed mortality across the groups (Figure 4).

Conclusion: Our study identified a prevalence of OH at 37%. The rate of falls resulting in hip fractures was highest in the Alzheimer’s disease group. The survival probability for patients with OH over 25 months is less than 60%.

Baseline characteristic of participants

Results of COMPASS-31

Frequency of Falls and Hip Fractures

Survival of Patients with Orthostatic Hypotension

Mortality Indicators Among the Four Patient Groups

References: 1. Low, P. A. (2008). Prevalence of orthostatic hypotension. Clinical Autonomic Research, 18, 8-13.
2. Kaufmann, H., Malamut, R., Norcliffe-Kaufmann, L., Rosa, K., & Freeman, R. (2012). The Orthostatic Hypotension Questionnaire (OHQ): validation of a novel symptom assessment scale. Clinical Autonomic Research, 22, 79-90.
3. Sletten, D. M., Suarez, G. A., Low, P. A., Mandrekar, J., & Singer, W. (2012, December). COMPASS 31: a refined and abbreviated Composite Autonomic Symptom Score. In Mayo Clinic Proceedings (Vol. 87, No. 12, pp. 1196-1201). Elsevier.

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