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  • Title: Autonomic dysfunction in elderly bedfast patients.
    Author: Kihara M, Takahashi M, Nishimoto K, Okuda K, Matsui T, Yamakawai T, Okumura A.
    Journal: Age Ageing; 1998 Sep; 27(5):551-5. PubMed ID: 12675092.
    Abstract:
    OBJECTIVE: to quantify autonomic function in bedfast elderly patients. PATIENTS AND METHODS: we analysed orthostatic blood pressure, heart rate response to tilt, heart rate response to deep breathing, quantitative sudomotor axon reflex test (QSART) and beat-to-beat blood pressure during phases II and IV of the Valsalva manoeuvre (VM) in 15 patients with (OH+) and without orthostatic hypotension (OH-) and 12 age-matched controls. RESULTS: all bedfast patients had a poor response in the late phase II of beat-to-beat blood pressure, while OH+ patients had an additional abnormality in phase IV. QSARTs in the distal leg and foot were decreased in both OH+ and OH- groups. There was no difference between the two groups in duration of being bedfast or in activities of daily living. CONCLUSIONS: (i) being bedfast results in postganglionic sympathetic dysfunction in the lower extremities; (ii) some patients who have beta-adrenergic dysfunction have OH and (iii) preventing patients from becoming being bedfast may be important for the maintenance of normal autonomic functions.
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