Orthostatic hypotension and physical functioning in older adults: A systematic review and meta-analysis

Arjen Mol, Esmee M. Reijnierse, Phuong Thanh Silvie Bui Hoang, Richard J.A. van Wezel, Carel G.M. Meskers, Andrea B. Maier*

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review

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Abstract

BACKGROUND: Orthostatic hypotension (OH) may negatively affect physical functioning and aggravate morbidities, but existing evidence is contradictory.

METHODS: MEDLINE (from 1946), PubMed (from 1966) and EMBASE databases (from 1947) were systematically searched for studies on the association of OH and physical functioning in older adults, categorized as: balance, gait characteristics, walking speed, Timed Up and Go time, handgrip strength (HGS), physical frailty, exercise tolerance, physical activity, activities of daily living (ADL), and performance on the Hoehn and Yahr scale (HY) and Unified Parkinson's Disease Rating Scale (UPDRS). Study quality was assessed using the Newcastle Ottawa Scale.

RESULTS: Forty-two studies were included in the systematic review (29,421 individuals) and 29 studies in the meta-analyses (23,879 individuals). Sixteen out of 42 studies reported a significant association of OH with worse physical functioning. Meta-analysis showed a significant association of OH with impaired balance, ADL performance and HY/UPDRS III performance, but not with gait characteristics, mobility, walking speed, TUG, HGS, physical frailty, exercise tolerance, physical activity and UPDRS II performance.

CONCLUSIONS: OH was associated with impaired balance, ADL performance and HY/UPDRS III performance, but not with other physical functioning categories. The results suggest that OH interventions could potentially improve some aspects of physical functioning.

Original languageEnglish
Pages (from-to)122-144
Number of pages23
JournalAgeing Research Reviews
Volume48
Early online date28 Oct 2018
DOIs
Publication statusPublished - Dec 2018

Funding

This work was supported by the Dutch Technology Foundation TTW [NeuroCIMT perspective grant 2015]; and the European Union’s Horizon 2020 research and innovation program [No 689238 , 2015; No 675003 , 2015]. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

FundersFunder number
Horizon 2020 Framework Programme689238, 675003

    Keywords

    • ADL
    • Balance
    • Gait
    • Handgrip strength
    • Timed up and go
    • Walking speed

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