Blood pressure and drug treatment in clinically diagnosed Lewy body dementia and Alzheimer's disease

The aim cf the study was to investigate arterial blood pressure (BP) and th e use of pharmacological treatment in patients with Lewy body dementia (cLB D) and Alzheimer's disease (cAD) diagnosed on clinical grounds. BP and phar macological treatment was analysed based on the medical records of 200 dece ased dementia patients. Forty-eight cases with LED and 45 AD were diagnosed using clinical criteria. The patients, who died between 1985 and 1994, wer e part of a prospective longitudinal dementia project. The majority of the cases were examined and cared for at the psychogeriatric and psychiatric de partments. BP levels were very similar at an early stage of dementia but th ere was a marked decrease during the course of dementia in cAD and cLBD. Th e cLBD cases became hypotensive during the course of dementia to a signific antly greater extent and also had a more pronounced drop in systolic BP at orthostatic testing compared to the cAD cases. cLBD and cAD were prescribed neuroleptics and medication potentially associated with hypotension to the same extent. The total number of these drugs was however higher in cLBD th an in cAD. Antiparkinsonian treatment was, as expected, more common in cLBD compared to cAD. The findings suggest that insufficient BP regulation and drug treatment could affect the clinical picture of dementia, particularly in cLBD patients, (C) 2000 Elsevier Science Ireland Ltd. All rights reserve d.