Session Information
Date: Monday, June 20, 2016
Session Title: Parkinson's disease: Non-motor symptoms
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To determine the prevalence of OH and identify risk factors associated with OH in Thai PD patients.
Background: Orthostatic hypotension (OH) represents one of the common non-motor manifestations (NMS) of Parkinson’s disease (PD) associated with falls and morbidity in affected patients.
Methods: 100 PD patients completed Orthostatic Hypotension Questionnaire (OHQ) and were evaluated for OH by measuring sitting and supine blood pressure (BP). OH was diagnosed if there is a reduction of systolic BP (SBP) of equal to or more than 20 mmHg and/or diastolic BP (DBP) of equal to or more than 10 mmHg after standing within 3 minutes. OH was determined to be symptomatic when the reduction of BP satisfy the above definition and OHQ score was more than 0. The presence of NMS was determined by the evaluation of Thai validated NMS questionnaire (TU-NMS Quest), and balance confidence was rated from the Activities-specific Balance Confidence (ABC) scale.
Results: Clinical demographics of 100 PD patients were shown in table 1. 22 patients were found to be OH, and most of the affected patients were found to be symptomatic (18 patients, 82%). Multiple logistic regression analysis revealed the presence of hypertension (OR=5.83), having non-motor symptoms in the domain “Cardiovascular and falls” from TU-NMS Quest (OR=3.37), and old age (OR=1.06) to be significant risk factors of OH in this cohort.
| Variables | Symptomatic OH (n=18) mean (SD) or n (%) | Non-symptomatic OH (n=82) mean (SD) or n (%) | p-value |
| Gender: male (%) | 10 (55.6) | 37 (45.1) | 0.42 |
| Age (years) | 69.7 (8.3) | 64.5 (12.0) | 0.04* |
| Hoehn&Yahn stage | 2.6 (0.5) | 2.5 (0.7) | 0.59 |
| PD duration (years) | 10.1 (5.9) | 9.0 (6.2) | 0.43 |
| Levodopa (%) | 18 (100.0) | 80 (97.6) | 0.50 |
| Entacapone (%) | 8 (44.4) | 41 (50.0) | 0.67 |
| Monoamine Oxidase-B inhibitors (%) | 3 (16.5) | 13 (15.9) | 0.93 |
| Dopamine Agonists (%) | 8 (44.4) | 44 (53.7) | 0.48 |
| Trihexyphenidyl (%) | 0 (0) | 13 (15.9) | 0.07 |
| Apomorphine (%) | 0 (0) | 2 (2.4) | 0.50 |
| Amantadine (%) | 1 (5.6) | 3 (3.7) | 0.71 |
| Levodopa equivalent daily dose (mg) | 624.3 (235.2) | 649.8 (347.0) | 0.74 |
| Polypharmacy***(%) | 12 (66.7) | 54 (65.8) | 0.95 |
| OHQ score | 1.2 (0.8) | 0.5 (0.7) | <0.001** |
| ABC score | 63.0 (5.6) | 63.0 (5.6) | 0.38 |
| Non-motor Domain (%) | |||
| 1. Sleep disorders and fatigue | 15 (83.3) | 62 (75.6) | 0.48 |
| 2. Cardiovascular and falls | 14 (78.8) | 43 (52.4) | 0.05* |
| 3. Mood and apathy | 5 (27.8) | 34 (41.5) | 0.28 |
| 4. Perception and hallucinations | 4 (22.2) | 28 (34.1) | 0.98 |
| 5. Memory and concentration | 11 (61.1) | 46 (56.1) | 0.70 |
| 6. Gastrointestinal tract | 13 (72.2) | 52 (63.4) | 0.48 |
| 7. Urinary tract | 10 (55.6) | 49 (59.8) | 0.73 |
| 8. Sexual disorders | 0 (0) | 16 (19.5) | 0.04* |
| 9. Others | 7 (38.9) | 52 (63.4) | 0.06 |
| 10. Impulse control disorders | 2 (11.1) | 16 (19.5) | 0.40 |
Conclusions: OH is a common NMS affecting 1 in 5 of our Thai PD patients. The presence of risk factors including hypertension, non-motor symptoms in the domain “Cardiovascular and falls” in the elderly PD patients should alert physicians to evaluate for the presence of OH so appropriate intervention can be taken in this high-risk patients.
To cite this abstract in AMA style:
S. Klanbut, S. Wongwiwatthananukit, C. Suthisisang, R. Bhidayasiri, S. Phattanarudee. Prevalence and risk factors of orthostatic hypotension in Thai Parkinson’s disease patients [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/prevalence-and-risk-factors-of-orthostatic-hypotension-in-thai-parkinsons-disease-patients/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-and-risk-factors-of-orthostatic-hypotension-in-thai-parkinsons-disease-patients/