Relationship between low blood pressure and depressive symptomatology in older people.
ABSTRACT To determine if low blood pressure is associated with a definable constellation of somatic and psychological symptoms in older persons.
A population-based study.
In-home interviews in five southwestern states.
A total of 2723 Mexican Americans aged 65 or older not living in institutions.
Blood pressure, Center for Epidemiologic Studies Depression Scale (CES-D), global self-rating of health, and self-esteem.
Bivariate analyses indicate a significant relationship between low blood pressure and increased depressive symptomatology; for example, systolic hypotensive subjects scored a CES-D mean of 12.07 +/- .67 compared to 8.99 +/- .95 for normotensives (P < .01). Regression analyses supported these findings when controlling for confounders such as gender, age, and use of antihypertensive medications. Subjects with low blood pressure also scored lower on self-esteem and global self-reported health and reported more days waking up feeling tired.
These data support the existence of a relationship between low blood pressure and higher levels of depressive symptomatology as well as a constellation of somatic and psychosocial symptoms.
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ABSTRACT: To examine the relationship between different types of physical exercise and the risk of subsequent fall-related injury. A prospective study of the home-dwelling elderly. A population sample of home-dwelling subjects aged 85 years or older (n = 512) in northern Finland participated in the study. Baseline data were collected by home-nursing staff through postal questionnaires and clinical tests. Frequency and times of physical exercise--that is, walking exercise and other exercise (home exercise, group exercise, gardening, cross-country skiing, dancing, swimming, bicycling)--and falls were recorded by a nurse examiner, who telephoned the participants 8 times during a 2-year follow-up period. Statistical analyses were based on Cox regressions and pooled logistic regressions. The risk of injury-causing falls was reduced by other exercise taken at least 1 hour per week compared with corresponding non-exercise; adjusted odds ratio 0.37 (0.19-0.72) but not by walking exercise. The risk of injury-causing falls was not increased by any kind or amount of exercise taken. Female sex, a history of recent fall-related injury and poor baseline near-vision acuity were the other significant predictors of injury-causing falls. Habitual physical exercise proved to be safe and some of the exercises were associated with reduced risk of subsequent fall-related injury. Female sex, an injury-causing fall in the recent past and problems with near vision increased the risk.International journal of circumpolar health 07/2008; 67(2-3):235-44. · 1.06 Impact Factor
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ABSTRACT: To review office management of elderly hypertensive patients and to focus on cognition and function both as ways to stratify who gets treated and as end points for treatment. Relevant papers were identified through a MEDLINE search from January 1994 to March 2000, using the MeSH terms hypertension, aged, aged 80 and over, cognition, activities of daily living, therapeutics, hypotension orthostatic, and dementia. Many well conducted randomized controlled trials were found and are included. Treatment of combined and systolic hypertension up to age 80 is clearly worthwhile; beyond age 85, other factors (chiefly cognitive and functional impairment) mitigate most routine recommendations. Successful treatment is individualized, taking into account comorbid conditions and their effect on cognition and function. Age is useful for thinking about groups, not individuals: as people age, risk of cognitive and functional impairment increases, but even very elderly people (> 85 years) with no impairment should be treated as younger patients are. Elderly people with signs of having a "brain at risk" should be managed with special vigilance. Good evidence supports treating elderly people, who are otherwise well and are cognitively and functionally intact, when their blood pressure is > 160 mm Hg systolic or > 105 mm Hg diastolic. There is insufficient evidence for carrying out routine recommendations for frail elderly people. Treatment of comorbid illnesses dictates choice of therapeutic agent.Canadian family physician Médecin de famille canadien 12/2001; 47:2520-5. · 1.41 Impact Factor