Characteristic analysis of autonomic dysfunction in patients with Alzheimer's disease

Abstract

Objective To investigate the autonomic nervous dysfunction in patients with Alzheimer's disease (AD) and its relationship with cognitive function. Methods A total of 160 AD patients were enrolled in Shanghai Jinshan Zhongren Aged Care Hospital from July 2020 to June 2021. Min⁃Mental State Examination (MMSE), Montreal Cognitive Assessment⁃Basic (MoCA⁃B) and Scale for Outcomes in Parkinson's Disease⁃Autonomic (SCOPA⁃AUT) were used to assess the cognitive and autonomic nervous function of AD patients, and the occurrence of orthostatic hypotension (OH) in AD were evaluated with the lying and standing blood pressure testing. Spearman rank correlation analysis was used to analyze the correlation between autonomic nervous function and cognitive function. Results Compared with the mild AD group, the scores of MMSE, MoCA⁃B and their subitems were lower (P=0.000, for all), and SCOPA⁃AUT score (P=0.000) and its subitem of digestive system (P=0.000), urinary system (P=0.000) and body temperature (P=0.001) were increased in the severe AD group. The incidence of OH was 32.22% (29/90). Spearman rank correlation analysis showed that the SCOPA⁃AUT sore (rs=⁃2.980, P=0.000; rs=⁃3.580, P=0.000) and its subitem of digestive system (rs=⁃2.730, P=0.000; rs=⁃3.160, P=0.000), urinary system (rs=⁃3.000, P=0.000; rs=⁃3.240, P=0.000) and body temperature (rs=⁃0.244, P=0.005; rs=⁃3.270, P=0.000) were negatively correlated with MMSE and MoCA⁃B scores. Conclusions The autonomic nervous dysfunction and its subitem of digestive system, urinary system and body temperature were significant correlated with the cognitive impairment in AD patients. However, there is a lower incidence of OH in AD.

Keywords

• alzheimer disease
• autonomic pathways
• cognition disorders
• neuropsychological tests