''Subclinical'' orthostatic hypotension is associated with dizziness in elderly patients with Parkinson disease

Objective: To investigate risk factors associated with subjective complaints of dizziness in 12 elderly patients with Parkinson disease (PD), in whom no obvious cause for this symptom could be found. Design: A case-controlled study, with patients prospectively recruited in a nonblinded fashion. Setting: Patients were seen by one physician at a neurology outpatient clinic between August 1993 and August 1994. Subjects: Thirty-six patients, air over age 65 years and all with PD; 12 complained of dizziness; 24 did not. Interventions: Patients and controls were screened for blood pressure: changes, postural instability, motor severity, multiple sensory deficits, drug use, cardiovscular disease, and diabetes mellitus. Main Outcome Measures: An orthostatic decrease of systolic BP > 15 mmHg (odds ratio = 6.5; 95% confidence interval = 1.22-34.52; chi(2)mh = 6.7;, p <.01) and an orthostatic decrease of diastolic BP > 5mmNg (odds ratio = 11; 95% confidence interval = 3.15-38.39; chi(2)mh = 7.14; p <.01) were significant risk factors for complaints of dizziness. Results: The only significant risk factors linked with dizziness were orthostatic decreases in systolic (15 mmHg) and diastolic (5mmHg) blood pressure. Conclusions: An orthostatic decrease in blood pressure is associated with unexplained feelings of dizziness in elderly PD patients. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.