Antidepressant use and orthostatic hypotension in older adults living with mild-to-moderate Alzheimer disease

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dc.contributor Molloy, D. William en
dc.contributor.author Dyer, Adam H.
dc.contributor.author Murphy, Claire
dc.contributor.author Briggs, Robert
dc.contributor.author Lawlor, Brian
dc.contributor.author Kennelly, Sean P. for the NILVAD Study Group
dc.date.accessioned 2020-09-11T10:46:10Z
dc.date.available 2020-09-11T10:46:10Z
dc.date.issued 2020-07-15
dc.identifier.citation Dyer, A. H., Murphy, C., Briggs, R., Lawlor, B. and Kennelly, S. P. for the NILVAD Study Group (2020) 'Antidepressant use and orthostatic hypotension in older adults living with mild-to-moderate Alzheimer disease', International Journal of Geriatric Psychiatry. doi: 10.1002/gps.5377 en
dc.identifier.issn 0885-6230
dc.identifier.uri http://hdl.handle.net/10468/10511
dc.identifier.doi 10.1002/gps.5377 en
dc.description.abstract Objectives: Antidepressant use is often reported as a risk factor for Orthostatic Hypotension (OH), however this relationship has never been explored in those with mild/moderate Alzheimer Disease (AD), who may represent a particularly vulnerable cohort. Methods: We performed a cross‐sectional analysis of baseline data from the NILVAD study. Participants with mild‐moderate AD were recruited from 23 centres in nine countries. Systolic and Diastolic Blood Pressure (SBP/DBP) was recorded in the seated position and after both 1 and 5 minutes of standing. OH was defined as a drop of ≥20 mmHg SBP/≥10 mmHg DBP. We examined the relationship between antidepressant use, orthostatic BP drop and the presence of OH, controlling for important covariates. Results: Of 509 participants (72.9 ± 8.3 years, 61.9% female), two‐fifths (39.1%; 199/509) were prescribed a regular antidepressant. Antidepressant use was associated with a significantly greater SBP and DBP drop at 5 minutes (β: 1.83, 0.16‐3.50, P = .03 for SBP; β: 1.13, 0.02‐2.25, P < .05 for DBP). Selective Serotonin Reuptake Inhibitor (SSRI) use was associated with a significantly greater likelihood of OH (OR 2.0, 1.1‐3.6, P = .02). Both findings persisted following robust covariate adjustment. Conclusions: In older adults with AD, antidepressants were associated with a significantly greater SBP/DBP drop at 5 minutes. SSRI use in particular may be a risk factor for OH. This emphasises the need to screen older antidepressant users, and particularly those with AD, for ongoing orthostatic symptoms in order to reduce the risk of falls in this vulnerable cohort. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons, Inc. en
dc.rights © 2020, John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Dyer, A. H., Murphy, C., Briggs, R., Lawlor, B. and Kennelly, S. P. for the NILVAD Study Group (2020) 'Antidepressant use and orthostatic hypotension in older adults living with mild-to-moderate Alzheimer disease', International Journal of Geriatric Psychiatry, doi: 10.1002/gps.5377, which has been published in final form at https://doi.org/10.1002/gps.5377. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. en
dc.subject Alzheimer's disease en
dc.subject Antidepressant en
dc.subject Dementia en
dc.subject Falls en
dc.subject Orthostatic hypotension en
dc.subject Selective-serotonin reuptake inhibitor en
dc.title Antidepressant use and orthostatic hypotension in older adults living with mild-to-moderate Alzheimer disease en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother David Molloy, Clinical Gerontology & Rehabilitation, University College Cork, Cork, Ireland. +353-21-490-3000 Email: w.molloy@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2021-07-15
dc.date.updated 2020-09-11T10:28:28Z
dc.description.version Accepted Version en
dc.internal.rssid 536173289
dc.internal.pmid 32668020
dc.contributor.funder Seventh Framework Programme en
dc.description.status Peer reviewed en
dc.identifier.journaltitle International Journal of Geriatric Psychiatry en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress w.molloy@ucc.ie en
dc.internal.bibliocheck In press. Check vol / issue / page range. Amend citation and copyright statement as necessary. en
dc.relation.project info:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/279093/EU/A European multicentre double-blind placebo-controlled phase III trial of nilvadIpine in mild to moderate Alzheimer’s disease/NILVAD en
dc.identifier.eissn 1099-1166


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