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Session: Sensors and pain
Session starts: Friday 25 January, 10:30
Presentation starts: 11:30
Room: Lecture room 558

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Arjen Mol (1Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands)
Esmee Reijnierse (Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, City Campus, Level 6 North, 300 Grattan Street, Parkville, Victoria 3050, Melbourne, Australia)
Marijke Trappenburg (Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands)
Richard van Wezel (Department of biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Faculty of Science, Huygensbuilding, Heijendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands)
Andrea Maier (Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit, Van der Boechorstraat 9, 1081 BT, Amsterdam, The Netherlands)
Carel Meskers (Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands)

Abstract:
Background: Orthostatic hypotension (OH) is a prevalent condition in older adults and is associated with impaired physical performance and falls. The ability of older adults to compensate for rapid changes in systolic blood pressure (SBP; i.e. SBP drop rate and SBP variability) may be important for physical performance. This study investigates the association of rapid SBP changes after standing up with physical performance. Methods and Results: Consecutive patients who visited the Center Of Geriatric Amsterdam (COGA) in 2014 and 2015 were included. The following SBP parameters were computed in two intervals (0-15 seconds and 15-180 seconds) after standing up: steepness of steepest SBP decline (SBPmax drop rate); ratio of standing and supine SBP variability (SBPvariability ratio); magnitude of largest SBP drop (SBPdrop magnitude). Physical performance was assessed using the following measures: chair stand time (CST), timed up and go time (TUG), walking speed, handgrip strength and tandem stance performance. 109 patients (45% male; age: mean 81.7 years (SD 7.0)) were included. SBPmax drop rate (0-15 seconds) was associated with slower CST (p < 0.001), TUG (p = 0.022) and walking speed (p = 0.024). SBPvariability ratio (0-15 seconds) was associated with slower CST (p = 0.005). SBPdrop magnitude was not associated with physical performance. Conclusions: SBP parameters reflecting rapid systolic blood pressure changes were more strongly associated with physical performance compared to SBP drop magnitude in geriatric outpatients. These results support the hypothesis of an inadequate cerebral autoregulation during rapid SBP changes and advocate the use of continuous BP measurements.