Autonomic dysfunction in patients with dementia of the Alzheimer type

Benedetto Vitiello, Richard C. Veith, Susan E. Molchan, Rick A. Martinez, Brian A. Lawlor, Jeanne Radcliffe, James L. Hill, Trey Sunderland

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)428-433
Number of pages6
JournalBiological psychiatry
Volume34
Issue number7
DOIs
StatePublished - Oct 1 1993

Keywords

  • Alzheimer's
  • epinephrine
  • norepinephrine

ASJC Scopus subject areas

  • Biological Psychiatry

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    Vitiello, B., Veith, R. C., Molchan, S. E., Martinez, R. A., Lawlor, B. A., Radcliffe, J., Hill, J. L., & Sunderland, T. (1993). Autonomic dysfunction in patients with dementia of the Alzheimer type. Biological psychiatry, 34(7), 428-433. https://doi.org/10.1016/0006-3223(93)90233-4