Do you get dizzy when you stand up? It could be a sign of dementia

Are you a middle-aged person who tends to feel a little dazed when you stand up?

If so, new research suggests that you may need to worry more than most about developing dementia later in life.

The study focused on a condition called orthostatic hypotension, in which blood pressure drops sharply when a person gets up quickly. This can trigger sudden symptoms such as dizziness, lightheadedness and blurred vision.

The condition is common in the elderly, and affects about 30 percent of people aged 70 or older, according to a recent study. It is much less common in young adults, but when it occurs, there are reasons for concern.

The researchers found that middle-aged people with the blood pressure condition were 54 percent more likely to develop dementia for the next 25 years, compared to those without the disease.

The reasons why they are not entirely clear, according to the principal investigator, Dr. Rebecca Gottesman. She is a professor of neurology at Johns Hopkins University in Baltimore.

But, said Gottesman, research has shown that health conditions that affect blood vessels, including high blood pressure and diabetes, are also linked to an increased risk of dementia. It is believed that altered blood flow to the brain could be the reason.

So in theory, Gottesman explained, repeated episodes of orthostatic hypotension could contribute to the risk of dementia by temporarily lowering the blood supply to the brain.

On the other hand, he said, in relatively younger people the condition could be a sign of generally poorer health and greater use of medications.

“Many medications, for high blood pressure and other conditions, can cause these drops in blood pressure,” Gottesman said.

His team tried to account for these other medical conditions. But, he said, it is not possible to account for everything.

The study included more than 11,700 American adults who were followed since the late 1980s, when they were between 40 and 50 years old, until 2013. At first, they underwent an orthostatic hypotension test, measuring blood pressure while they were lying down, and then again after they stood up.

Just under 5 percent had orthostatic hypotension: they had a 20-point drop in systolic pressure when standing up, or a 10-point decrease in diastolic pressure. The systolic pressure is in the blood vessels when the heart beats, while the diastolic pressure is when the heart rests.

In the next 25 years, according to the study, 12.5 percent of people with this condition developed dementia, compared with 9 percent of people who did not have this condition.

People with orthostatic hypotension were relatively older and had higher rates of high blood pressure and diabetes. But even after the researchers explained it, it was still related to an increased risk of developing dementia.

Dr. Anil Nair is director of the Alzheimer’s Disease Center in Quincy, Massachusetts.

He said the findings add to the evidence that cardiovascular health is important in the risk of dementia.

Nair noted that two-thirds of the study participants with this condition also had high blood pressure, and most of those people were taking medication for it.

Since that medication can cause orthostatic hypotension, he suggested that people with potential symptoms talk to their doctor about their treatment regimen.

“The ideal is to control hypertension, without over-treating it,” Nair said.

Gottesman agreed, suggesting that patients with symptoms should talk with their doctors about all their medications. “If there is a simple change of medication that can be done, it’s worth talking about that,” he said.

However, people do not always notice the symptoms. In this study, it was detected through blood pressure tests. It is not clear, said Gottesman, how many people actually experienced symptoms in their daily lives.

Therefore, if you are taking medications that can cause orthostatic hypotension, it would be advisable to ask your doctor to measure your blood pressure when you stand up, Gottesman advised.

Even if the underlying cause is unclear, simply knowing that you have the condition can be helpful, he added.

Those patients can pay more attention to maintaining a healthy lifestyle and controlling any other condition that affects the blood vessels and the heart, Gottesman said.

The findings were published online July 25 in the journal Neurology.

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