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A systematic review and meta-analysis on the association between orthostatic hypotension and mild cognitive impairment and dementia in Parkinson’s disease

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A Correction to this article was published on 17 January 2023

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Abstract

Background

Cognitive impairment is a frequent disabling feature of Parkinson’s disease (PD). Orthostatic hypotension (OH) is treatable and may be a risk factor for cognitive impairment.

Objective

We conducted a systematic review and meta-analysis to examine the relationship between OH with PD-associated minimal cognitive impairment (PD-MCI) and dementia (PDD) and assess the mitigating effects of potential confounding factors.

Methods

Observational studies published in English, Spanish, French, or Portuguese up to January 2022 were searched for in PubMed, EBSCO, and SciELO databases. The primary aim of this study was to revise the association between OH with PD-MCI and PDD. Alongside, we assessed OH as related to cognitive rating scales. Fixed and random models were fitted. Meta-regression was used to assess the mitigating effects of confounding variables.

Results

We identified 18 studies that reported OH association with PDD or PD-MCI, 15 of them reporting OH association with cognitive rating scales. OH was significantly associated with PDD/PD-MCI (OR, 95% CI: 3.31, 2.16–5.08; k = 18, n = 2251; p < 0.01). OH association with PDD (4.64, 2.68–8.02; k = 13, n = 1194; p < 0.01) was stronger than with PD-MCI (1.82, 0.92–3.58; k = 5, n = 1056; p = NS). The association between OH and PD-MCI/PDD was stronger in studies with a higher proportion of women and in those with a lower frequency of supine hypertension. Global cognition rating scale scores were lower in patients with OH (SMD, 95% CI: − 0.55, − 0.83/ − 0.26; k = 12, n = 1427; p < 0.01).

Conclusions

Orthostatic hypotension shows as a significant risk factor for cognitive impairment in PD, especially in women and patients not suffering from hypertension.

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Data Availability

Data is available upon request to the authors.

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Authors and Affiliations

  1. Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina

    Débora Loureiro, Rodrigo Bilbao, Osvaldo J. Ponzo & Santiago Perez-Lloret

  2. Centro de Altos Estudios en Ciencias Humanas y de la Salud, Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas, CACEIHS, UAI-CONICET, Buenos Aires, Argentina

    Sofía Bordet, Matilde Otero-Losada & Francisco Capani

  3. Centro de Investigaciones en Psicología y Psicopedagogía, Facultad de Psicología y Psicopedagogía, Pontificia Universidad Católica Argentina, CIPP, UCA, Buenos Aires, Argentina

    Sofía Bordet & Lina Grasso

  4. Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile

    Francisco Capani

  5. Observatorio de Salud Pública, Pontificia Universidad Católica Argentina, Consejo Nacional de Investigaciones Científicas y Técnicas, Av. Alicia Moreau de Justo 1300, C1107, Buenos Aires, Argentina

    Santiago Perez-Lloret

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Contributions

Research project = SPLL, OJP.

Data collection and evaluation = DL, RB.

Data analysis = SPLL, SB, LG.

Manuscript preparation = SPLL.

Academic editing (grammar and style) and proofreading: MOL.

Manuscript revision = DL, RB, SB, LG, FC, MOL, OJP.

Corresponding author

Correspondence to Santiago Perez-Lloret.

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The original online version of this article was revised: The above article was published with error. The author Francisco Capani contains only two affiliations instead of four. This has been corrected here.

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Loureiro, D., Bilbao, R., Bordet, S. et al. A systematic review and meta-analysis on the association between orthostatic hypotension and mild cognitive impairment and dementia in Parkinson’s disease. Neurol Sci 44, 1211–1222 (2023). https://doi.org/10.1007/s10072-022-06537-3

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