Clinical and autonomic profile of patients with Alzheimer's disease and mixed dementia

Objective

To analyze the clinical and autonomic profile of patients with Alzheimer's disease or mixed dementia (MD).

Methods

Fifty-four patients with indication for cholinesterase inhibitors use were evaluated through clinical examination, rest electrocardiogram, and spectral analysis of heart rate (HR) variability through digital Holter system recordings.

Results

Overall, 61.1% of patients were females and were, on average, 77.1 years of age, had 3.3 years of schooling, and scored 16.4 points on the Mini Mental State Examination. The gap between symptom onset and diagnosis was 26.2 months. Almost all patients (90.7%) presented at least one clinical comorbidity, and each patient took, on average, 3.7 drugs to control them. Thirty-one patients had some alteration on the electrocardiogram, and nine (16.6%) had orthostatic hypotension (OH). The latter was associated with the diagnosis of MD (p = 0.001), with lower values of low (LF) and high (HF) frequency components of the spectral analysis in the supine position (p = 0.000 and p = 0.017, respectively), and with lower values of LF in the orthostatic position (p = 0.006). Diagnosis of MD was associated with lower values of LF in both positions (p = 0.003 and p = 0.007).

Conclusion

This sample of patients had frequent comorbidities, which resulted in the prescription of multiple drugs. Signs of autonomic dysfunction resulting in OH were found mainly in those with MD.