Trial reportThe journals of gerontology. Series A, Biological sciences and medical sciences2020
Orthostatic Blood Pressure Recovery Is Associated With the Rate of Cognitive Decline and Mortality in Clinical Alzheimer's Disease.
Trial report in The journals of gerontology. Series A, Biological sciences and medical sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Long-term antipsychotic use, orthostatic hypotension and falls in older adults with Alzheimer's disease.European geriatric medicine · 2024Trial
- The feasibility of a set of physical resilience measurements in older patients admitted to the acute medical unit.BMC geriatrics · 2025Article
- Beat-to-Beat Blood Pressure Monitoring and Orthostatic Hypotension-Related Falls in Two Cohorts of Older Adults.Geriatrics (Basel, Switzerland) · 2025Article
- Preoperative physical resilience indicators and their associations with postoperative outcomes.GeroScience · 2025Article
- Dysautonomia in Alzheimer's Disease: A Systematic Review.Brain sciences · 2025Review
- No association between markers of systemic inflammation and endothelial dysfunction with Alzheimer's disease progression: a longitudinal study.GeroScience · 2025Article
- Associations of Orthostatic Hypotension and Frailty With Dementia and Mortality in Older Adults: A Population-Based Cohort Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Safety and feasibility of transcutaneous vagus nerve stimulation in mild cognitive impairment: VINCI-AD study protocol.BMC neurology · 2023Article
- Reduced cardiovagal baroreflex sensitivity is associated with postural orthostatic tachycardia syndrome (POTS) and pain chronification in patients with headache.Frontiers in human neuroscience · 2023Article
- Cerebral autoregulation assessed by near-infrared spectroscopy: validation using transcranial Doppler in patients with controlled hypertension, cognitive impairment and controls.European journal of applied physiology · 2021Article
- Network Physiology in Aging and Frailty: The Grand Challenge of Physiological Reserve in Older Adults.Frontiers in network physiology · 2021Article
- Orthostatic hypotension is not associated with small vessel disease progression or cognitive decline.Cerebral circulation - cognition and behavior · 2021Review
- Longitudinal changes in the control mechanisms for blood pressure and cerebral blood flow in Alzheimer's disease: Secondary results of a randomized controlled trial.Cerebral circulation - cognition and behavior · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImpaired recovery of blood pressure (BP) after standing has been shown to be related to cognitive function and mortality in people without dementia, but its role in people with Alzheimer's disease (AD) is unknown. The aim of this study was to investigate the association of the orthostatic BP response with cognitive decline and mortality in AD.
methodsIn this post hoc analysis of a randomized controlled trial (Nilvad), we measured the beat-to-beat response of BP upon active standing in mild-to-moderate AD. This included the initial drop (nadir within 40 seconds) and recovery after 1 minute, both expressed relative to resting values. We examined the relationship between a small or large initial drop (median split) and unimpaired (≥100%) or impaired recovery (<100%) with 1.5-year change in Alzheimer's Disease Assessment-cognitive subscale (ADAS-cog) scores and all-cause mortality.
resultsWe included 55 participants (age 73.1 ± 6.2 years). Impaired BP recovery was associated with higher increases in ADAS-cog scores (systolic: β [95% confidence interval] = 5.6 [0.4-10.8], p = .035; diastolic: 7.6 [2.3-13.0], p = .006). During a median follow-up time of 49 months, 20 participants died. Impaired BP recovery was associated with increased mortality (systolic: HR [95% confidence interval] = 2.9 [1.1-7.8], p = .039; diastolic: HR [95% confidence interval] = 5.5 [1.9-16.1], p = .002). The initial BP drop was not associated with any outcome. Results were adjusted for age, sex, and intervention group.
conclusionsFailure to fully recover BP after 1 minute of standing is associated with cognitive decline and mortality in AD. As such, BP recovery can be regarded as an easily obtained marker of progression rate of AD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.