{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:21:11Z","timestamp":1783405271455,"version":"3.54.6"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Orthostatic hypotension (OH) commonly impairs the quality of life and prognosis of patients with neurodegenerative disorders. Since skeletal muscle functions as a peripheral pump for blood pressure stabilization and a reservoir for intracellular water, we investigated its association with body composition in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cross-sectional study included 86 patients with neurodegenerative disorders from Parkinsonism-related Multidisciplinary Clinic in Peking Union Medical College Hospital (PUMCH), including multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and other atypical parkinsonian syndromes (APS). OH was defined as a sustained reduction in systolic blood pressure of \u226520\u202fmmHg or diastolic blood pressure of \u226510\u202fmmHg within 3\u202fmin of active standing. Participants were divided into with OH and without OH (non-OH). Body composition was measured via Bioelectrical Impedance Analysis (BIA). The measured values were normalized to height squared to generating indices such as the fat-free mass index (FFMI) and appendicular muscle mass index (AMI). Clinical scores, levodopa equivalent daily dosage (LEDD), and grip strength were compared between groups. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 (AWGS2019) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of OH was 45.3%, significantly higher in MSA (58.0%) than in PSP (13.3%). Sarcopenia prevalence did not differ significantly between groups. Elastic net and support vector machine (SVM) analysis identified lower limb extracellular water index (LLEWI) and AMI as the most predictive body composition indicators for OH. Linear regression confirmed AMI as an independent negative predictor of orthostatic systolic blood pressure change (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22124.69,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.008).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate that OH is significantly associated with decreased AMI and lower LLEWI. Measuring these indices may offer valuable insights into OH risk, potentially serving as a more sensitive early indicator than a formal diagnosis of sarcopenia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1830578","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:47:53Z","timestamp":1783403273000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between body composition and orthostatic hypotension in patients with neurodegenerative disorders in parkinsonism-related multidisciplinary clinic"],"prefix":"10.3389","volume":"18","author":[{"given":"Jin","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Shanghai Ninth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wengkei","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Peking Union Medical College Hospital Macau Medical Center, Avenida do Hospital do Cotai","place":["Macau, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1136\/jnnp.2003.029413","article-title":"Frequency of orthostatic hypotension in a community based cohort of patients with Parkinson\u2019s disease","volume":"75","author":"Allcock","year":"2004","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s00415-022-11347-w","article-title":"Autonomic dysfunction in progressive supranuclear palsy","volume":"270","author":"Baschieri","year":"2023","journal-title":"J. Neurol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"269","DOI":"10.3109\/08037051.2016.1169633","article-title":"Lean mass influences overnight changes in hydration, blood pressure and strength in community-dwelling older women","volume":"25","author":"Benton","year":"2016","journal-title":"Blood Press."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"219","DOI":"10.14283\/jfa.2020.72","article-title":"Muscle loss is associated with risk of orthostatic hypotension in older men and women","volume":"10","author":"Benton","year":"2021","journal-title":"J. Frailty Aging"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1038\/ajh.2010.146","article-title":"Morbidity and mortality of orthostatic hypotension: implications for management of cardiovascular disease","volume":"24","author":"Benvenuto","year":"2011","journal-title":"Am. J. Hypertens."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"5281","DOI":"10.3390\/ijms24065281","article-title":"Genetics of multiple system atrophy and progressive supranuclear palsy: a systemized review of the literature","volume":"24","author":"Bougea","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2703","DOI":"10.1002\/mds.28768","article-title":"Orthostatic hypotension in Parkinson's disease: do height and weight matter?","volume":"36","author":"Campese","year":"2021","journal-title":"Mov. Disord."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s13054-023-04309-9","article-title":"Perioperative changes in fluid distribution and haemodynamics in acute high-risk abdominal surgery","volume":"27","author":"Cihoric","year":"2023","journal-title":"Crit. Care"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1038\/s41581-024-00817-1","article-title":"Long-term health outcomes associated with hydration status","volume":"20","author":"Dmitrieva","year":"2024","journal-title":"Nat. Rev. Nephrol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1007\/s41999-023-00775-0","article-title":"Relationship between sarcopenia and orthostatic blood pressure recovery in older falls clinic attendees","volume":"14","author":"Duggan","year":"","journal-title":"Eur Geriatr Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1093\/gerona\/glac243","article-title":"Differential associations between two markers of probable sarcopenia and continuous orthostatic Hemodynamics in the Irish longitudinal study on ageing","volume":"78","author":"Duggan","year":"","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1002\/ana.25834","article-title":"Validation of the neurogenic orthostatic hypotension ratio with active standing","volume":"88","author":"Fanciulli","year":"2020","journal-title":"Ann. Neurol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s10286-011-0119-5","article-title":"Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome","volume":"21","author":"Freeman","year":"2011","journal-title":"Clin Auton Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1007\/s00415-016-8375-x","article-title":"The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension","volume":"264","author":"Gibbons","year":"2017","journal-title":"J. Neurol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1152\/physrev.1943.23.3.220","article-title":"Physiological study of the vertical stance of man","author":"Hellebrandt","year":"1943","journal-title":"Physiological Reviews"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1002\/mds.26987","article-title":"Clinical diagnosis of progressive supranuclear palsy: the movement disorder society criteria","volume":"32","author":"H\u00f6glinger","year":"2017","journal-title":"Mov. Disord."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"25","DOI":"10.5606\/tftrd.2021.5461","article-title":"Orthostatic hypotension and age-related sarcopenia","volume":"67","author":"Keskin","year":"2021","journal-title":"Turk J Phys Med Rehabil."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1212\/wnl.0000000000004058","article-title":"Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium","volume":"89","author":"McKeith","year":"2017","journal-title":"Neurology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1002\/mdc3.70142","article-title":"Prevalence of supine hypertension in alpha-Synucleinopathies: a systematic review and meta-analysis","volume":"12","author":"Moss Lopes","year":"2025","journal-title":"Mov Disord Clin Pract."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1136\/jnnp-2018-319374","article-title":"Association of autonomic symptoms with disease progression and survival in progressive supranuclear palsy","volume":"90","author":"Oliveira","year":"2019","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson's disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov. Disord."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1212\/wnl.46.5.1470","article-title":"Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The consensus committee of the American autonomic society and the American academy of neurology","volume":"46","author":"Schatz","year":"1996","journal-title":"Neurology"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1161\/HYPERTENSIONAHA.121.18580","article-title":"Mitigating initial orthostatic hypotension: mechanistic roles of muscle contraction vs sympathetic activation","volume":"79","author":"Sheikh","year":"","journal-title":"Hypertension"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1016\/j.hrthm.2021.12.030","article-title":"Lower body muscle preactivation and tensing mitigate symptoms of initial orthostatic hypotension in young females","volume":"19","author":"Sheikh","year":"","journal-title":"Heart Rhythm."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1097\/00008483-198804000-00013","article-title":"Reliability of the activities of daily living scale and its use in telephone interview","volume":"8","author":"Shinar","year":"1987","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1093\/ageing\/afaa077","article-title":"Relationship between sarcopenia and orthostatic hypotension","volume":"49","author":"Soysal","year":"2020","journal-title":"Age Ageing"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"H1216","DOI":"10.1152\/ajpheart.00738.2003","article-title":"Decreased skeletal muscle pump activity in patients with postural tachycardia syndrome and low peripheral blood flow","volume":"286","author":"Stewart","year":"2004","journal-title":"Am. J. Phys. Heart Circ. Phys."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1111\/j.1475-097X.1996.tb00565.x","article-title":"Cardiac output and blood pressure during active and passive standing","volume":"16","author":"Tanaka","year":"1996","journal-title":"Clin. Physiol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1804","DOI":"10.1212\/01.wnl.0000125192.69777.6d","article-title":"Autonomic dysfunction in dementia with Lewy bodies","volume":"62","author":"Thaisetthawatkul","year":"2004","journal-title":"Neurology"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"100310","DOI":"10.1016\/j.prdoa.2025.100310","article-title":"Autonomic dysfunction in progressive supranuclear palsy: a retrospective study","volume":"12","author":"Wang","year":"2025","journal-title":"Clin Park Relat Disord."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1136\/jnnp.67.5.620","article-title":"Time course of symptomatic orthostatic hypotension and urinary incontinence in patients with postmortem confirmed parkinsonian syndromes: a clinicopathological study","volume":"67","author":"Wenning","year":"1999","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1002\/mds.29005","article-title":"The Movement Disorder Society criteria for the diagnosis of multiple system atrophy","volume":"37","author":"Wenning","year":"2022","journal-title":"Mov. Disord."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/S1474-4422(22)00169-7","article-title":"Diagnosis and treatment of orthostatic hypotension","volume":"21","author":"Wieling","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1042\/CS20060091","article-title":"Initial orthostatic hypotension: review of a forgotten condition","volume":"112","author":"Wieling","year":"2007","journal-title":"Clin Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1136\/jnnp.72.6.721","article-title":"Incidence and prediction of falls in Parkinson\u2019s disease: a prospective multidisciplinary study","volume":"72","author":"Wood","year":"2002","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"6329","DOI":"10.1007\/s10072-022-06296-1","article-title":"Prevalence and associated factors of frailty and sarcopenia in multiple system atrophy and progressive supranuclear palsy: a cross-sectional study","volume":"43","author":"Xie","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"4693","DOI":"10.1111\/bph.16504","article-title":"The role of venous capacity in fluid retention with endothelin a antagonism: mathematical modelling of the RADAR trial","volume":"181","author":"Yu","year":"2024","journal-title":"Br. J. Pharmacol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1186\/s12877-022-03546-x","article-title":"Orthostatic hypotension is associated with malnutrition diagnosed by GLIM in elderly hypertensive patients","volume":"22","author":"Zhang","year":"2022","journal-title":"BMC Geriatr."}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2026.1830578\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:47:54Z","timestamp":1783403274000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2026.1830578\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":40,"alternative-id":["10.3389\/fnagi.2026.1830578"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2026.1830578","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"article-number":"1830578"}}