AUTONOMIC DYSFUNCTION IN ELDERLY BEDFAST PATIENTS

Objective: to quantify autonomic function in bedfast elderly patients. Patients and methods: we analysed orthostatic blood pressure, heart r ate response to tilt, heart rate response to deep breathing, quantitat ive sudomotor axon reflex test (QSART) and beat-to-beat blood pressure during phases II and TV of the Valsalva manoeuvre (VM) in 15 patients with (OH+) and without orthostatic hypotension (OH-) and 12 age-match ed controls. Results: all bedfast patients had a poor response in the late phase II of beat-to-beat blood pressure, while OH+ patients had a n additional abnormality in phase TV. QSARTs in the distal leg and foo t were decreased in both OHS and OH- groups. There was no difference b etween the two groups in duration of being bedfast or in activities of daily living. Conclusions: (i) being bedfast results in postganglioni c sympathetic dysfunction in the lower extremities; (ii) some patients who have beta-adrenergic dysfunction have OH and (iii) preventing pat ients from becoming being bedfast may be important for the maintenance of normal autonomic functions.