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Original article| Volume 34, ISSUE 7, P428-433, October 01, 1993

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Autonomic dysfunction in patients with dementia of the Alzheimer type

DOI:https://doi.org/10.1016/0006-3223(93)90233-4
Autonomic dysfunction in patients with dementia of the Alzheimer type
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      Abstract

      Abnormalities of the noradrenergic system have been documented in the central nervous system of patients with dementia of the Alzheimer's type (DAT). To evaluate the autonomic sympathetic system in DAT, we measured lying and standing blood pressure (BP), pulse, and plasma epinephriine (E) and norepinephrine (NE) in 60 DAT patients (mean age ± SD = 65 ± 8 years), and 20 normal elderly controls. DAT patients had normal baseline findings (BP, pulse, NE, and E). Upon standing, plasma NE and E significantly increased in both DAT patients and controls, without group differences. However, the systolic BP response to standing was reduced in DAT patients compared with the normal controls (repeated measures ANOVA, p < 0.01). This impaired response of the systolic BP on standing was particularly evident in DAT patients with symptoms of depression. Severely impaired DAT patients did not differ in E, NE, BP, pulse, or in orthostatic changes from mild-to-moderately impaired patients. These results suggest that the sympathetic response to the stress of standing is functionally impaired in DAT. This deficit was especially evident when DAT was accompanied by depression, consistent with prior studies in non-demented depressed patients.

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      Article info

      Publication history

      Received in revised form: March 12, 1993
      Received: September 11, 1992

      Footnotes

      ☆An earlier version of this paper was presented at the 46th Annual Convention of the Society of Biological Psychiatry, May 1991, New Orleans, LA

      Identification

      DOI: https://doi.org/10.1016/0006-3223(93)90233-4

      Copyright

      © 1993 Published by Elsevier Inc.

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