ArticleNeurology2023
Association Between Orthostatic Hypotension and Dementia in Patients With Parkinson Disease and Multiple System Atrophy.
Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 43 papers, 3 of them syntheses that pooled it.
What it found
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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
43 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- The causative role of amyloidosis in the cardiac complications of Alzheimer's disease: a comprehensive systematic review.The Journal of physiology · 2026Pooled it
- Cerebral Blood Flow Dynamics in Neurogenic Orthostatic Hypotension: A Systematic Review and Meta-Analysis.Hypertension (Dallas, Tex. : 1979) · 2025Pooled it
- Prevalence and incidence of orthostatic hypotension in patients with Parkinson's disease: an updated systematic review and meta-analysis.Frontiers in neurologyPooled it
- Autonomic debate: symptoms are an optimal target for orthostatic hypotension screening and management. An argument in opposition.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- Symptoms are an optimal target for orthostatic hypotension screening and management: an argument in favor.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Review
- Cognitive Fluctuations, Neuropsychiatric Burden, and Quality of Life in Moderate-Advanced Dementia With Lewy Bodies: The Role of Dysautonomia.Neurology · 2026Observational
- Early Autonomic Burden in Prodromal Parkinson's Disease Predicts Cognitive Impairment.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Cognitive and behavioral disturbances in PSP and MSA: clinical features and imaging correlates.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Predictive factors of global cognitive impairment in de novo Parkinson disease with normal cognition at baseline: a 10-year cohort study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Exercise-Induced Oxygen Desaturation and Cognitive Performance in Patients with Parkinson's Disease: A Prospective Observational Study.Journal of clinical medicine · 2026Article
- Cumulative incidence and risk factors of dementia in Parkinson's disease and parkinsonism: a population-based study.Brain communications · 2026Article
- Cerebral hemodynamic changes and their effects on cognitive function in patients with Parkinson's disease complicated with orthostatic hypotension.Clinical parkinsonism & related disorders · 2026Article
- Approach to Cardiovascular Autonomic Dysfunction in Patients with Synucleinopathies.Movement disorders clinical practice · 2025Review
- Orthostatic hypotension in Parkinson's disease-More than just lightheadedness and fainting.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- Enhanced visual illusions in Parkinson's disease with cardiovascular autonomic failure.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- LRRK2 p.G2385R and p.R1628P variants in a multi-ethnic Asian Parkinson's Cohort: epidemiology and clinical insights.NPJ Parkinson's disease · 2025Article
- Supine hypertension and cardiovascular disease: controversies and advances.Future cardiology · 2025Review
- A reset on our reclined position-a call to prioritize neurogenic supine hypertension in the synucleinopathies.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Review
- Review
- Orthostatic Hypotension and Cognition in Lewy Body Disorders: On Promising Tides.Movement disorders : official journal of the Movement Disorder Society · 2025Article
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesOrthostatic hypotension (OH) increases dementia risk in patients with Parkinson disease (PD), although the underlying mechanisms and whether a similar association between OH and cognitive impairment exists in other synucleinopathies remain unknown. The aim is to evaluate the association between OH and dementia risk in patients with PD, and cognitive impairment risk in patients with multiple system atrophy (MSA), and to explore relevant clinical and neuropathologic factors to understand underlying pathogenic mechanisms.
methodsThis is a retrospective cohort study. Medical records throughout the entire disease course of consecutive patients with neuropathology-confirmed PD and MSA from the Queen Square Brain Bank were systematically reviewed. Time of onset and severity of OH-related symptoms were documented, and their association with other clinical and neuropathologic variables was evaluated. Dementia risk for patients with PD and cognitive impairment risk for patients with MSA were estimated using multivariable hazard regression.
resultsOne hundred thirty-two patients with PD and 137 with MSA were included. Patients with MSA developed OH more frequently, earlier in the disease course and with more severe symptoms. Cumulative dementia prevalence was higher in patients with PD. Multivariable adjusted regression models showed that early OH, but not its symptom severity, increased dementia risk in patients with PD by 14% per year (hazard ratio [HR] = 0.86; 95% CI, 0.80-0.93) and cognitive impairment risk in patients with MSA by 41% per year (HR = 0.59; 95% CI, 0.42-0.83). Early OH was not associated with increased α-synuclein, β-amyloid, tau, Alzheimer, or cerebrovascular pathologies. No significant associations were found between severity of OH symptoms and other clinical or neuropathologic variables. DISCUSSION: Early OH, but not its symptom severity, increases the risk of cognitive impairment in patients with PD and MSA. OH is not associated with more extensive Lewy, β-amyloid, tau, Alzheimer, or cerebrovascular pathologies. It is likely that OH contributes to cognitive impairment in patients with PD and MSA by hypoxia-induced nonspecific neurodegeneration. Further research should evaluate whether improving brain perfusion by treating OH may modify the risk of dementia in these conditions.
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