Autonomic dysfunction in dementia

L.M. Allan, C.G. Ballard, J. Allen, A. Murray, A.W. Davidson, I.G. McKeith, R.A. Kenny

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

Background: There are no studies of autonomic function comparing Alzheimer’s disease (AD), vascular dementia (VAD), dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD). Aims: To assess cardiovascular autonomic function in 39 patients with AD, 30 with VAD, 30 with DLB, 40 with PDD and 38 elderly controls by Ewing’s battery of autonomic function tests and power spectral analysis of heart rate variability. To determine the prevalence of orthostatic hypotension and autonomic neuropathies by Ewing’s classification. Results: There were significant differences in severity of cardiovascular autonomic dysfunction between the four types of dementia. PDD and DLB had considerable dysfunction. VAD showed limited evidence of autonomic dysfunction and in AD, apart from orthostatic hypotension, autonomic functions were relatively unimpaired. PDD showed consistent impairment of both parasympathetic and sympathetic function tests in comparison with controls (all p<0.001) and AD (all p<0.03). DLB showed impairment of parasympathetic function (all p<0.05) and one of the sympathetic tests in comparison with controls (orthostasis; p = 0.02). PDD had significantly more impairment than DLB in some autonomic parameters (Valsalva ratio: p = 0.024; response to isometric exercise: p = 0.002). Patients with VAD showed impairment in two parasympathetic tests (orthostasis: p = 0.02; Valsalva ratio: p = 0.08) and one sympathetic test (orthostasis: p = 0.04). These results were in contrast with AD patients who only showed impairment in one sympathetic response (orthostasis: p = 0.004). The prevalence of orthostatic hypotension and autonomic neuropathies was higher in all dementias than in controls (all p<0.05).
Original languageEnglish
Pages (from-to)671-677
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume78
Issue number7
Early online date18 Dec 2006
DOIs
Publication statusPublished - 15 Jun 2007
Externally publishedYes

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    Allan, L. M., Ballard, C. G., Allen, J., Murray, A., Davidson, A. W., McKeith, I. G., & Kenny, R. A. (2007). Autonomic dysfunction in dementia. Journal of Neurology, Neurosurgery and Psychiatry, 78(7), 671-677. https://doi.org/10.1136/jnnp.2006.102343