Cardiovascular characteristics and cerebral CT findings in elderly subjects with psychomotor disadaptation syndrome.
OBJECTIVE
In previous studies, we described a clinical picture typically observed in frail old people, called "Psychomotor Disadaptation Syndrome" (PDS), but we have never studied etiopathogenic data. The aim of this study was to complete the clinical picture, record cardiovascular risk factors and provide cerebral CT scan findings in patients with PDS.


METHODS
73 patients with PDS were recruited in the Geriatric Medicine departments of the University Hospitals of Dijon (Burgundy, France) and Strasbourg (Alsace, France); this group included prospectively all hospitalized patients showing postural and gait abnormalities according to the following criteria: trend towards backward falling and gait pattern alteration characterized by hesitancy in initiation, small steps, and increase in the double support durations. General characteristics, neurological and cardiovascular information were collected for each patient. For the detection of white matter changes (WMC), we used a third-generation CT scanner (GE CT HSA) evaluating a section of 7 mm at each interval of 8 mm.


RESULTS
Neurological examination showed that "reactional hypertonia" was observed in more than 90% of the patients, and that no patient showed normal reactive postural responses. Prior history of hypertension was noted in 49% of the patients, while a current antihypertensive treatment was taken by 13% of the patients. Orthostatic hypotension was observed in 44% of patients. Severe or moderate periventricular lucencies on CT scan were found in 67% of the patients, and severe ventricular enlargement in 50.5% of the patients.


CONCLUSIONS
We advance that PDS might be associated with WMC, and that hypotension might be an important etiologic factor of WMC in causing reduction of the cerebral blood flow in subcortical areas.
Pfitzenmeyer
Pierre
P
Service de Médecine Gériatrique, Centre Hospitalier Régional et Université de Dijon, France. ppfitzenmeyer@chu-dijon.fr
Martin-Hunyadi
Catherine
C
Mourey
France
F
d'Athis
Philippe
P
Baudouin
Nathalie
N
Mischis-Troussard
Christelle
C
D000368:Aged; D000369:Aged, 80 and over; D002552:Cerebral Ventricles / Q000473:pathology; D002560:Cerebrovascular Circulation; D005260:Female; D016330:Frail Elderly; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007024:Hypotension, Orthostatic / Q000150:complications* / Q000453:epidemiology; D008297:Male; D009122:Muscle Hypertonia / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D011187:Posture; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed