Cognitive and motor function of orthostatic hypotension patient taking alpha-blocker for benign prostate hypertrophy – Preliminary study
Poster presented by Hee Kwon Park, Jong-Hyun Ahn, JiWon Kwon, Soo-Jeong Kim, Eung-Seok Lee, Cindy Yoon, Eun-Ki Kim, Joung-Ho Rha Incheon, Korea, Republic of.
Objective: To investigate the neurological consequence of alpha-blocker induced orthostatic hypotension (OH) in the benign prostate hypertrophy (BPH) patients.
Background: Alpha-blocker is usually prescribed for BPH management, but adverse effect of OH frequently follows, and its clinical impact has not been well studied.
Design/Method: BPH patients (≥65 years old) who had taken alpha-blocker ≥1 year and agreed on this study were prospectively selected from the urology clinic. Patient with previous history of OH, stroke, or dementia was excluded. For the diagnosis of OH, all patients took head-up tilt table test. Neuropsychological assessment including mini-mental state exam (MMSE) and Montreal cognitive assessment (MoCA), along with motor function assessment by unified Parkinson disease rating scale (UPDRS) were also performed in some patients. MMSE score ≤25 were defined as mild cognitive impairment (MCI). Comparative analysis was made between patients with OH and patients without (control).
Results: From April 2011 to March 2012, total 51 patients (age 69.7±8, all male) were enrolled. Among them, OH was identified in 31 subjects (61%). MCI was diagnosed in 15 and the proportion was not different between OH group and control (32 vs. 25%, p=0.58). However, the OH group showed tendency of more impaired digit forward span than the control (4.9±1.7 vs. 5.7±1.4, p=0.08), which became significant in the older subgroup (≥71y, 4.3±1.2 vs. 5.9±1.2, p=0.01). OH group also showed significantly impaired motor function reflected by much higher UPDRS motor score (14.8±13.5 vs. 3.7±4.8, p=0.02) compared to the control.
Conclusions: Substantial portion of BPH patients taking alpha-blocker develop OH. This “induced” OH had no significant effect on cognitive function, but it might be possibly associated with working memory impairment and motor slowing in the elderly. Further confirmative investigation would be necessary.