Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)

Comprehensive geriatric assessment decreases prevalence of orthostatic hypotension in older persons




Julkaisun tekijät: Lampela P, Lavikainen P, Huupponen R, Leskinen E, Hartikainen S

Kustantaja: SAGE PUBLICATIONS LTD

Julkaisuvuosi: 2013

Journal: Scandinavian Journal of Public Health

Tietokannassa oleva lehden nimi: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH

Lehden akronyymi: SCAND J PUBLIC HEALT

Numero sarjassa: 4

Volyymi: 41

Julkaisunumero: 4

Sivujen määrä: 8

ISSN: 1403-4948

DOI: http://dx.doi.org/10.1177/1403494813475533


Tiivistelmä
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