Refereed journal article or data article (A1)

Comprehensive geriatric assessment decreases prevalence of orthostatic hypotension in older persons




List of AuthorsLampela P, Lavikainen P, Huupponen R, Leskinen E, Hartikainen S

PublisherSAGE PUBLICATIONS LTD

Publication year2013

JournalScandinavian Journal of Public Health

Journal name in sourceSCANDINAVIAN JOURNAL OF PUBLIC HEALTH

Journal acronymSCAND J PUBLIC HEALT

Number in series4

Volume number41

Issue number4

Start page351

End page358

Number of pages8

ISSN1403-4948

DOIhttp://dx.doi.org/10.1177/1403494813475533


Abstract
Background: Orthostatic hypotension (OH) is associated with significant morbidity and mortality among older people. We have studied whether its prevalence can be reduced by a Comprehensive Geriatric Assessment (CGA). Study design and setting: 1000 randomly-selected persons aged ayen75 years were divided into intervention (n = 500) and control groups (n = 500). We focused on those subjects in whom an orthostatic blood pressure test had been performed at least once during the study period (2004-2007) (n = 365 and 332 for intervention and control groups, respectively). A CGA, including evaluation of the adequacy of the medication, was performed annually in the intervention group but not in the control group. We conducted Markov models to study change in the OH profiles and the effect of CGA on it. Competing risk of mortality was modeled as an absorbing state to avoid attrition bias. Results: Over 3 years, the prevalence of OH decreased (35.0% -> 28.0%) in the intervention group, whereas its prevalence increased in the control group (32.8% -> 40.8%). By Markov models it was shown that CGA had a statistically significant effect on recovering from OH. In addition, CGA was shown to protect from developing OH. Conclusions: Repeated CGA performed annually can reduce the prevalence of OH.


Last updated on 2021-24-06 at 09:39