Objective: To define features of cognitive decline in a group of patients with orthostatic hypotension combined with sleep disorders.

Background: recent data suggest that orthostatic hypotension (OH) and REM-sleep disorders (RBD) are parts of the same pathological process [1]. RBD can be predictor of cognitive decline [2]. OH is usually accompanied by cognitive impairment [3]. “Poor” sleepers may have cognitive decline for different reasons [4].

Method: we observed 14 patients with Parkinson’s disease (PD) and 16 patients with cerebrovascular disease (CVD) (small vessel disease or chronic phase of ischemic stroke). In all of them, OH was combined with RBD or poor sleep quality.

We hypothesized that there might be a difference in cognitive functions between the group with OH and RBD and the group with OH and “poor” sleepers.

We used the Montreal Cognitive Assessment (MoCA), the REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) and the Pittsburgh Sleep Quality Index (PSQI) for the study.

Results: the combination of OH and RBD was associated with higher cognitive decline. OH and “poor” sleepers had less effect on cognitive ability. There was a lower PSQI score in patients with RBD [table 1].

Conclusion: the combination of RBD and OH could mean a neurodegenerative process with a worse outcome. Whereas a combination of OH with “poor” sleepers may be part of aging or slowly progressing neurodegeneration. According to our research, we recommend that all patients with OH undergo RBDSQ, PSQI and MoCA.

References: 1. Yin, K., Zhou, C., Zhu, Y., Yin, W., Yin, L., Liu, B., … & Yang, X. (2022). REM sleep behavioral disorder may be an independent risk factor for orthostatic hypotension in Parkinson’s disease. Aging Clinical and Experimental Research, 34(1), 159-166.
2. Maggi, G., Trojano, L., Barone, P., & Santangelo, G. (2021). Sleep disorders and cognitive dysfunctions in Parkinson’s disease: a meta-analytic study. Neuropsychology Review, 1-40.
3. Iseli, R., Nguyen, V. T. V., Sharmin, S., Reijnierse, E. M., Lim, W. K., & Maier, A. B. (2019). Orthostatic hypotension and cognition in older adults: a systematic review and meta-analysis. Experimental gerontology, 120, 40-49.
4. Li, J., Cao, D., Huang, Y., Chen, Z., Wang, R., Dong, Q., … & Liu, L. (2021). Sleep duration and health outcomes: an umbrella review. Sleep and Breathing, 1-23.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-orthostatic-hypotension-with-sleep-disturbance-on-cognition/