Citation

Shanbhag A, Awai H, Rej S, Thomas AJ, Puka K, Vasudev A. Int. J. Geriatr. Psychiatry 2018; 33(10): 1397-1402.

Affiliation

Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1002/gps.4951

PMID

30043432

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.

© 2018 John Wiley & Sons, Ltd.

Language: en

Keywords

Orthostatic Hypotension Questionnaire; late life depression; orthostatic hypotension