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The Association of Cardiovascular Disorders and Falls: A Systematic Review
Sofie Jansen1, Jaspreet Bhangu2, Sophia de Rooij3
1Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Insights
Cardiovascular disorders like low blood pressure, heart failure, and arrhythmia are linked to falls in older adults. Identifying these conditions can help improve fall prevention strategies for seniors.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiovascular disorders are significant risk factors for falls in the elderly population.
- Effective fall prevention requires understanding the specific cardiovascular conditions contributing to falls.
Purpose of the Study:
- To systematically review and identify cardiovascular disorders associated with falls in older adults.
- To provide insights for optimizing fall-preventive care strategies.
Main Methods:
- A systematic review of studies indexed in Medline and Embase.
- Inclusion criteria focused on individuals aged 50 and older with reported cardiovascular risk factors for falls.
- Study quality was assessed using the Newcastle-Ottawa Scale.
Main Results:
- Eighty-six studies were included in the review.
- Consistent associations with falls were found for low blood pressure (BP), heart failure, and cardiac arrhythmia.
- While conditions like carotid sinus hypersensitivity (CSH) and vasovagal syncope (VVS) were more prevalent in fallers, clear association measures were often lacking. Associations for coronary artery disease, orthostatic hypotension, and hypertension were inconsistent.
Conclusions:
- Low BP, heart failure, and arrhythmia are key cardiovascular factors associated with falls in older adults.
- Further research is needed to standardize definitions and quantify the precise contribution of individual risk factors to fall incidence.
- These findings offer avenues for enhancing fall prevention programs and interventions.
Objective:
Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care.
Design:
Systematic review.
Data Sources:
Medline and Embase.
Eligibility Criteria For Selecting Studies:
studies addressing persons aged 50 years and older that described cardiovascular risk factors for falls. Key search terms for cardiovascular abnormalities included all synonyms for the following groups: structural cardiac abnormalities, cardiac arrhythmia, blood pressure abnormalities, carotid sinus hypersensitivity (CSH), orthostatic hypotension (OH), vasovagal syncope (VVS), postprandial hypotension (PPH), arterial stiffness, heart failure, and cardiovascular disease. Quality of studies was assed using the Newcastle-Ottawa Scale.
Results:
Eighty-six studies were included. Of studies that used a control group, most consistent associations with falls were observed for low blood pressure (BP) (4/5 studies showing a positive association), heart failure (4/5), and cardiac arrhythmia (4/6). Higher prevalences of CSH (4/6), VVS (2/2), and PPH (3/4) were reported in fallers compared with controls in most studies, but most of these studies failed to show clear association measures. Coronary artery disease (6/10), orthostatic hypotension (9/25), general cardiovascular disease (4/9), and hypertension (7/25) all showed inconsistent associations with falls. Arterial stiffness was identified as an independent predictor for falls in one study, as were several echocardiographic abnormalities.
Conclusion:
Several cardiovascular associations with falls were identified, including low BP, heart failure, and arrhythmia. These results provide several angles for optimizing fall-preventive care, but further work on standard definitions, as well as the exact contribution of individual risk factors on fall incidence is now important to find potential areas for preventive interventions.
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