title: Autonomic dysfunction in Alzheimer's disease: tools for assessment and review of the literature.
abstract: Autonomic dysfunction is very common in patients with dementia, and its presence might also help in differential diagnosis among dementia subtypes. Various central nervous system structures affected in Alzheimer's disease are also implicated in autonomic nervous system regulation, and it has been hypothesized that the deficit in central cholinergic function observed in Alzheimer's disease could likely lead to autonomic dysfunction. Several feasible tests can be used in clinical practice for the assessment of parasympathetic and sympathetic functions, especially in terms of cardiovascular autonomic modulation. In this review, we describe the different tests available and the evidence from the literature which indicate a definite presence of autonomic dysfunction in dementia at various degrees. Importantly, the recognition of dysautonomia, besides possibly being an early marker of dementia, would help prevent the disabling complications which increase the risk of morbidity, institutionalization, and mortality in these individuals.
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Grazia Daniela
authors.initials: GD
authors.lastname: Femminella
authors.affiliation: Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese, Telese Terme (BN), Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rengo
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Klara
authors.initials: K
authors.lastname: Komici
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Iacotucci
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Petraglia
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Pagano
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: de Lucia
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Canonico
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonaduce
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Leosco
authors.affiliation: Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese, Telese Terme (BN), Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
mesh_terms: D000544:Alzheimer Disease / Q000150:complications*; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans
keywords: Alzheimer's disease; autonomic nervous system; baroreflex; functional recovery; orthostatic hypotension