Symptoms of Orthostatic Hypotension and Drugs Affecting Autonomic Function are Associated with the Onset of Frailty in Community-Dwelling Persons Aged 80 Years and Above: A Prospective Observational Study.

IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Aziz Debain, Fien Loosveldt, Veerle Knoop, Axelle Costenoble, Jordy Saren, Mirko Petrovic, Ivan Bautmans
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Abstract

Background: Both autonomic dysfunction and frailty are common and complex geriatric syndromes with similar negative health outcomes. Both conditions are characterized by a loss of homeostasis that makes individuals more vulnerable to stressors.

Aim: The primary aim of this study is to examine the association between drugs that affect autonomic function and frailty onset in community-dwelling octogenarians. The secondary aim is to investigate the relationship between autonomic dysfunction and frailty onset in this population.

Methods: In total, 372 nonfrail adults aged 80 years and above (mean age 83 ± 3 years) from the BUTTERFLY project were prospectively followed for 2 years (mean follow-up of 22 ± 6 months). The association between autonomic dysfunction (defined as neurogenic orthostatic hypotension and symptoms of orthostatic hypotension), the use of medications affecting autonomic function, and frailty status were examined using binary logistic regression analysis.

Results: The completely adjusted binary logistic regression model showed that the use of drugs affecting autonomic function was associated with frailty {adjusted odds ratio (aOR) = 1.78 [95% confidence interval (CI) 1.06-3.00], p = 0.030}. Furthermore, symptoms of orthostatic hypotension were related to frailty (aOR = 2.98 [95% CI 1.13-7.88], p = 0.027).

Conclusions: Our results show that symptoms of orthostatic hypotension and the use of drugs that affect autonomic function are accompanied with respectively 3-fold and 1.8-fold higher odds of frailty onset in persons aged 80 years and over. Therefore, pharmacological treatment that affects autonomic function should be started with caution and timely discontinued in older persons.

一项前瞻性观察研究:80岁及以上社区居民的体位性低血压症状和影响自主神经功能的药物与虚弱的发生有关
背景:自主神经功能障碍和虚弱都是常见而复杂的老年综合征,具有相似的负面健康结果。这两种情况的特点都是体内平衡的丧失,使个体更容易受到压力源的影响。目的:本研究的主要目的是研究影响自主神经功能的药物与社区居住的八旬老人虚弱发作之间的关系。第二个目的是研究这一人群中自主神经功能障碍与虚弱发作之间的关系。方法:对来自BUTTERFLY项目的372例80岁及以上(平均83±3岁)非体弱成人进行2年的前瞻性随访(平均22±6个月)。自主神经功能障碍(定义为神经源性直立性低血压和直立性低血压症状)、影响自主神经功能的药物使用和虚弱状态之间的关系采用二元logistic回归分析。结果:经完全校正的二元logistic回归模型显示,影响自主神经功能的药物的使用与虚弱相关{校正优势比(aOR) = 1.78[95%可信区间(CI) 1.06 ~ 3.00], p = 0.030}。此外,体位性低血压症状与虚弱相关(aOR = 2.98 [95% CI 1.13-7.88], p = 0.027)。结论:我们的研究结果表明,在80岁及以上的人群中,体位性低血压症状和影响自主神经功能的药物的使用分别伴随着3倍和1.8倍的脆弱性发作。因此,影响自主神经功能的药物治疗应谨慎开始,并在老年人中及时停用。
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来源期刊
Drugs & Aging
Drugs & Aging 医学-老年医学
CiteScore
5.50
自引率
7.10%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Drugs & Aging delivers essential information on the most important aspects of drug therapy to professionals involved in the care of the elderly. The journal addresses in a timely way the major issues relating to drug therapy in older adults including: the management of specific diseases, particularly those associated with aging, age-related physiological changes impacting drug therapy, drug utilization and prescribing in the elderly, polypharmacy and drug interactions.
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