Key result
Orthostatic hypotension in older adults was significantly associated with a reduced composite equilibrium score (AUC 0.833; 95% CI 0.778-0.887; p<0.001), indicating decreased sensory integration.
Why the study?
Orthostatic hypotension is common in older adults and predisposes to balance disorders and falls, but quantitative evaluation of balance indicators using computerized dynamic posturography was needed.
Does orthostatic hypotension affect balance function in older adults?
Cross-Sectional (n=303)
Does orthostatic hypotension affect balance function in older adults?
Effect estimate: AUC 0.833 (95% CI 0.778-0.887)
p-value: p=<0.001
Older individuals with orthostatic hypotension have decreased sensory integration for balance, making them more prone to falls.
Suggests computerized dynamic posturography may help quantify fall risk in older adults with orthostatic hypotension.
Background: Orthostatic hypotension (OH) is a common blood pressure abnormality in older adults that makes them prone to balance disorders and falls. The maintenance of balance relies on a complex regulatory system. The use of computerized dynamic posturography (CDP) can provide a quantitative evaluation of balance function. The objective of this study was to utilize CDP to measure balance indicators in older individuals with OH. Methods: A total of 303 older adults were divided into an OH group of 91 and a non-OH group of 212. Various factors, including chronic diseases, medication history, laboratory tests, and balance indicators, were compared between the two groups. Results: ① Participants with OH had more chronic diseases, including coronary heart disease (p = 0.049) and a history of falls (p < 0.001), than those without OH. A history of multiple medications in the OH group was significantly more likely than in the non-OH group (p = 0.006). ② There was a significant reduction in the composite equilibrium score (SOT-COM) (p < 0.001), vision ratio score (VIS) (p < 0.001), vestibular ratio score (VEST) (p < 0.001), and directional control (DCL) (p = 0.028) in the OH group. ③ A logistic regression analysis revealed that SOT-COM was a significant independent factor associated with OH. The area under the curve (AUC) of SOT-COM was 0.833 (95% confidence interval: 0.778–0.887, p < 0.001), with a sensitivity of 0.826 and a specificity of 0.759. Conclusions: This study demonstrates that older individuals with OH are more prone to falls, due to decreased sensory integration for balance.
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Cui et al. (2023) conducted a cross-sectional in Orthostatic hypotension (n=303). Orthostatic hypotension vs. No orthostatic hypotension was evaluated on Composite equilibrium score (SOT-COM) as a predictor of orthostatic hypotension (AUC 0.833, 95% CI 0.778-0.887, p=<0.001). Orthostatic hypotension in older adults was significantly associated with a reduced composite equilibrium score (AUC 0.833; 95% CI 0.778-0.887; p<0.001), indicating decreased sensory integration.
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