Orthostatic Hypotension and Associated Factors among Home Care Clients Aged 75 Years or Older - A Population-Based Study.

OBJECTIVES: The aim of this study was to examine orthostatic hypotension (OH) and associated factors among home care clients aged 75 years or older.

DESIGN: Non-randomised controlled study.

SETTING AND PARTICIPANTS: The study sample included 244 home care clients aged 75 years or older living in Eastern and Central Finland.

MEASUREMENTS: Nurses, nutritionists and pharmacists collected clinical data including orthostatic blood pressure, depressive symptoms (15-item Geriatric Depression Scale GDS-15), nutritional status (Mini Nutritional Assessment MNA), drug use, self-rated health, daily activities (Barthel ADL Index and Lawton and Brody IADL scale) and self-rated ability to walk 400 metres. Comorbidities were based on medical records.

RESULTS: The prevalence of OH was 35.7% (n = 87). No association between OH and the number of drugs used or causative drug use and OH was found. In univariate analysis, coronary heart disease, systolic and diastolic blood pressure in a sitting position and lower mean MNA scores were associated with a risk of OH. Multivariate analysis showed that lower mean MNA scores (OR 1.140, 95% CI: 1.014-1.283) appeared to be independently connected to a risk of OH.

CONCLUSION: One-third of the home clients had OH and it was associated with lower MNA scores.