Session Time: 1:15pm-2:45pm
Location: Hall 3FG
Objective: The purpose of this study was to investigate the correlation of hemodynamic parameters and cognition in patients with PD.
Background: Cognitive impairment is common and one of most troublesome complication in Parkinson’s disease (PD). Beyond the Lewy-related pathology, vascular pathology owing to blood pressure (BP) dysregulation is known to affect cognitive decline in PD. However, whether cognitive impairment in PD is related to orthostatic hypotension (OH) and/or supine hypertension (SH) has not been well established.
Methods: Twenty eight patients with PD were recruited, Mini-mental Status Examination (MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating (CDR) were checked for all patients. Autonomic function test and 24-hour ambulatory blood pressure monitoring were recorded. Patients were stratified by the presence of OH and SH based on orthostatic BP recording.
Results: Among 28 patients, 15 showed normal BP response (OH- group) and 13 showed OH (OH+ group) during tilt table test. Twenty two patients was classed as SH- group, 6 classed as SH+ group. OH+ group were older and showed more severe parkinsonian motor symptoms (UPDRS part III). Language function was significantly impaired in OH + group. Correlation analysis showed that ΔSBP (ΔSBP= SBPsupine – SBP tilt) correlated to MMSE_language (r=-0.426, p=0.027) and CDR_sum of box (r=0.402, p=0.042). After adjusting the confounding factors (age, disease duration, Levodopa equivalent dose, education duration, hypertension, diabetes) ΔSBP showed significant correlation to MMSE_total score (r=-0.519, p=0.027), MMSE_attention&calculation (r=-0.575, p=0.013), MMSE_language (p=-0.644, p=0.004). On the other hand, SH showed no significant association with cognitive impairment (R2=0.001, p=0.884).
Conclusions: Our results suggest that orthostatic hypotension affects cognitive decline, but not supine hypertension. Especially, attention&calculation and language functions were affected to OH, after adjusting the confound factors. Therefore, we suggest that OH as a modifiable factor in the cognitive decline of PD, should be more actively correct OH to maintain the cognitive function in PD.
To cite this abstract in AMA style:H. Jeong. Effects of orthostatic hypotension and supine hypertension on cognition in Parkinson’s disease [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/effects-of-orthostatic-hypotension-and-supine-hypertension-on-cognition-in-parkinsons-disease/. Accessed December 1, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-orthostatic-hypotension-and-supine-hypertension-on-cognition-in-parkinsons-disease/