title: Ambulatory blood pressure monitoring in older people with dementia: a systematic review of tolerability.
abstract: ambulatory blood pressure monitoring (ABPM) may be helpful for the management of hypertension, but little is known about its tolerability in people with dementia.
  
  
  
  to review the published evidence to determine the tolerability of ABPM in people with dementia.
  
  
  
  English language search conducted in MEDLINE and EMBASE, using 'Ambulatory blood pressure' AND 'Dementia' (and associated synonyms) from 1996 to March 2015.
  
  
  
  people diagnosed with dementia AND in whom blood pressure was measured using ABPM. The initial search was undertaken using title and abstract reviews, with selected papers being agreed for inclusion by two reviewers. Potentially eligible papers were assessed, and high-quality papers were retained. Two reviewers agreed the abstracted data for analysis. Meta-analysis was used to combine results across studies.
  
  
  
  of the 221 screened abstracts, 13 studies (6%) met inclusion criteria, 5 had sufficient data and were of sufficient quality, involving 461 participants, most of whom had mild-moderate dementia. 77.7% (95% CI 62.2-93.2%) were able to tolerate ABPM; agreement with office BP was moderate to weak (two studies only-coefficients 0.3-0.38 for systolic blood pressure and 0.11-0.32 for diastolic blood pressure). One study compared home BP monitoring by a relative or ambulatory BP monitoring with office BP measures and found high agreement (κ 0.81). The little available evidence suggested increased levels of dementia being associated with reduced tolerability.
  
  
  
  ABPM is well tolerated in people with mild-moderate dementia and provides some additional information over and above office BP alone. However, few studies have addressed ABPM in people with more severe dementia.
authors.affiliation: University of Leicester School of Medicine, Leicester LE1 5WW, UK.
authors.forename: Simon Paul
authors.initials: SP
authors.lastname: Conroy
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology & The Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, UK.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Harrison
authors.affiliation: Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Veronika
authors.initials: V
authors.lastname: Van Der Wardt
authors.affiliation: Geriatric Medicine, Nottingham University Hospitals, Nottingham, UK.
authors.forename: Rowan
authors.initials: R
authors.lastname: Harwood
authors.affiliation: Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Pip
authors.initials: P
authors.lastname: Logan
authors.affiliation: Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: Tomas
authors.initials: T
authors.lastname: Welsh
authors.affiliation: Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.
authors.forename: John R F
authors.initials: JR
authors.lastname: Gladman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: ambulatory blood pressure monitoring; dementia; hypertension; older people