title: Oscillometric measure of blood pressure detects association between orthostatic hypotension and depression in population based study of older adults.
abstract: BACKGROUND
  White matter hyperintensities may contribute to depression by disrupting neural connections among brain regions that regulate mood. Orthostatic hypotension (OH) may be a risk factor for white matter hyperintensities and accumulating evidence, although limited suggests it may play a role in the development of late-life depression. The aim of this study was to examine the relationship between an oscillometric measure of orthostatic hypotension and depression in population based sample of older adults.
  
  
  METHODS
  We analysed data on adults aged 60 and over from the first wave of The Irish Longitudinal Study on Ageing (TILDA). Depression was assessed using the Center for Epidemiologic Studies--Depression (CES-D) scale and OH was assessed by a sit-to-stand orthostatic stress test; two seated blood pressure measurements were followed by a single standing blood pressure measurement. Participants self reported whether they felt dizzy, light-headed or unsteady on standing.
  
  
  RESULTS
  Participants with symptomatic OH (SOH, n=20) had the highest mean CES-D score (mean 8.6, SE 1.6) when compared to participants with asymptomatic OH (AOH) (mean 5.6, SE .48) and participants with no OH (mean 5.2, SE .14) and this difference was significant for both comparisons (p<0.001). Linear regression analysis adjusted for socio-demographic and clinical characteristics showed that SOH was associated with higher CES-D scores (unstandardised B coefficient = 2.24; 95% CI .301 - 4.79; p =0.05) compared to participants without OH. AOH was not associated with higher CES-D scores (unstandardised B coefficient =.162; 95% CI -.681, 1.00; p= 0.70).
  
  
  CONCLUSIONS
  Symptomatic orthostatic hypotension is associated with depression in older adults and needs to be considered in studies examining the relationship between vascular disease and depression in older adults.
authors.affiliation: The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College, Dublin, Ireland. oreganc1@tcd.ie.
authors.forename: Claire O
authors.initials: CO
authors.lastname: Regan
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kearney
authors.forename: Hilary
authors.initials: H
authors.lastname: Cronin
authors.forename: George M
authors.initials: GM
authors.lastname: Savva
authors.forename: Brian A
authors.initials: BA
authors.lastname: Lawlor
authors.forename: Roseanne
authors.initials: R
authors.lastname: Kenny
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000453:epidemiology* / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D012307:Risk Factors