SUBCLINICAL ORTHOSTATIC HYPOTENSION IS ASSOCIATED WITH DIZZINESS IN ELDERLY PATIENTS WITH PARKINSON DISEASE

Objective: To investigate risk factors associated with subjective comp laints of dizziness in 12 elderly patients with Parkinson disease (PD) , in whom no obvious cause for this symptom could be found. Design: A case-controlled study, with patients prospectively recruited in a nonb linded fashion. Setting: Patients were seen by one physician at a neur ology outpatient clinic between August 1993 and August 1994. Subjects: Thirty-six patients, air over age 65 years and all with PD; 12 compla ined of dizziness; 24 did not. Interventions: Patients and controls we re screened for blood pressure: changes, postural instability, motor s everity, multiple sensory deficits, drug use, cardiovscular disease, a nd diabetes mellitus. Main Outcome Measures: An orthostatic decrease o f systolic BP > 15 mmHg (odds ratio = 6.5; 95% confidence interval = 1 .22-34.52; chi(2)mh = 6.7;, p <.01) and an orthostatic decrease of dia stolic BP > 5mmNg (odds ratio = 11; 95% confidence interval = 3.15-38. 39; chi(2)mh = 7.14; p <.01) were significant risk factors for complai nts of dizziness. Results: The only significant risk factors linked wi th dizziness were orthostatic decreases in systolic (15 mmHg) and dias tolic (5mmHg) blood pressure. Conclusions: An orthostatic decrease in blood pressure is associated with unexplained feelings of dizziness in elderly PD patients. (C) 1996 by the American Congress of Rehabilitat ion Medicine and the American Academy of Physical Medicine and Rehabil itation.