A doctoral student in Binghamton’s Decker School of Nursing hopes her research will resolve questions related to blood pressure and wandering in patients with Alzheimer’s disease.
Olympia Berger is a family nurse practitioner at the Greater Binghamton Health Center, where she cares for patients with severe mental illness.
“Some of my geriatric patients wander,” Berger says. “I noticed that as their blood pressure dropped, I saw some cognitive changes.”
That led her to studying the effects of hypotension (for these purposes, a systolic reading of 140 or lower) on cognitive function, and to a theory that low blood pressure may trigger wandering. Decrease in regional cerebral blood flow is common in individuals with Alzheimer’s. In fact, patients who wander may have more advanced pathology and a more pronounced decrease in cerebral blood flow. “No one has looked at changes in blood pressure before, during and after an episode of wandering,” Berger says. “Is that the body’s mechanism to increase cerebral blood flow?”
Berger notes that not all Alzheimer’s patients wander. Those who do — more often men than women — aren’t looking to go anywhere; they just seem to need to move. She has seen patients get up and walk when they’re in pain, even soon after having surgery.
Working with her advisor, Carolyn Pierce, an assistant professor of nursing and of bioengineering, Berger is following a small group of patients using an ambulatory blood pressure monitoring device. They hope to identify peak times for wandering to see if there are connections to mealtimes or blood pressure.
One idea they’re exploring is that senior citizens may need a higher blood pressure than younger people. If that’s true, it may suggest changes in blood-pressure medication and diet for this population.
For Berger, there’s no question that psychiatric and medical issues are related. “You need,” she says, “to look at the whole person.”