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Orthostatic hypotension in patients with late-life depression: Prevalence and validation of a new screening tool.
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- Author(s): Shanbhag, Amruta; Awai, Helen; Rej, Soham; Thomas, Alan J.; Puka, Klajdi; Vasudev, Akshya
- Source:
International Journal of Geriatric Psychiatry. Oct2018, Vol. 33 Issue 10, p1397-1402. 6p. 2 Charts, 1 Graph. - Source:
- Additional Information
- Subject Terms: ORTHOSTATIC hypotension; MENTAL depression; SYSTOLIC blood pressure; QUESTIONNAIRES; GAIT in humans; GERIATRIC assessment; BLOOD pressure; COMPARATIVE studies; ACCIDENTAL falls; RESEARCH methodology; MEDICAL cooperation; MEDICAL screening; RESEARCH; RESEARCH funding; LOGISTIC regression analysis; EVALUATION research; PREDICTIVE tests; DISEASE prevalence; CROSS-sectional method
- Subject Terms:
- Abstract:
Objectives: The objective of this study was to assess the prevalence of orthostatic hypotension (OH) in a sample of late life depression (LLD) patients and to determine the validity of a standardized questionnaire, the Orthostatic Hypotension Questionnaire (OHQ). Secondarily, we wished to assess variables associated with OH.Methods: We conducted a cross-sectional study on 82 consecutive geriatric outpatients presenting with LLD. OH was defined as a fall in systolic blood pressure of greater than 20 mm Hg and/or 10 mm Hg on diastolic blood pressure on an orthostatic stress test from sitting to standing. Logistic regressions were used to identify factors associated with OH.Results: The prevalence of OH as measured on the orthostatic stress test and on the OHQ was 28% and 57%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the OHQ were 69.6% (95% CI 47%-87%), 47.5% (95%CI 34%-61%), 0.54 (95% CI: 0.43-0.64), 34% (95%CI 21%-49%), and 80% (95%CI 63%-92%), respectively. Females were more likely to have OH (OR: 3.96, 95%CI 1.06-14.89, P = .041), and those married or in a common-law relationship were less likely to have OH (OR: 0.25, 95% CI 0.08-0.72, P = .011).Conclusions: OH is common in patients with LLD conferring them a risk of gait instability and falls. Females had a higher risk of having OH while participants who were married or in a common-law relationship were less likely to have OH. Although the OHQ is a quick to administer paper-based screening test, it did not show adequate diagnostic accuracy in patients with LLD seen in a routine psychiatry clinic. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of International Journal of Geriatric Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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