Hypotensive episodes consistently preceded and were time-locked to cognitive fluctuations in patients with Parkinson's disease dementia, independent of carbidopa/levodopa dosing.
Are cognitive fluctuations temporally associated with hypotensive episodes in patients with Parkinson's disease dementia and neurogenic orthostatic hypotension?
Hypotensive episodes may be an under-recognized contributor to cognitive fluctuations in Parkinson's disease dementia, suggesting that ambulatory blood pressure monitoring could help guide management.
Absolute Event Rate: 0% vs 0%
Abstract Background Cognitive fluctuations (CFs) are a disabling feature in Parkinson's disease dementia (PDD) and contribute to caregiver burden. The relationship between CFs and neurogenic orthostatic hypotension (nOH), a common autonomic complication in PDD, has not been adequately examined. Cases We describe four patients with PDD and nOH with caregiver‐reported CFs manifesting as impaired attention, comprehension, language, and visuospatial skills. Each patient underwent bedside assessment for orthostatic vital signs and 24‐hour ambulatory blood pressure monitoring (ABPM). CFs were consistently time‐locked to periods of hypotension, independent of carbidopa/levodopa dosing. Conclusions Hypotensive episodes may be under‐recognized contributors to CFs in PDD. Interventions targeting hypotension warrant further investigation as potential strategies to mitigate CFs. Incorporation of ABPM into routine clinical evaluation may help guide their management.
Patino et al. (Mon,) reported a other. Hypotensive episodes consistently preceded and were time-locked to cognitive fluctuations in patients with Parkinson's disease dementia, independent of carbidopa/levodopa dosing.