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Effectiveness of Cardiovascular Evaluations and Interventions on Fall Risk: A Scoping Review
S Luiting1, S Jansen, L J Seppälä
1Nathalie van der Velde, PhD, Amsterdam University Medical Center, Department of Internal Medicine, Section of Geriatric Medicine, Meibergdreef 9, Amsterdam 1105AZ, the Netherlands, Tel. nr: +31 20-5665991,
Insights
Cardiovascular interventions significantly reduce fall risk in older adults. This review highlights the need for standardized cardiovascular assessments to prevent falls and improve quality of life.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiovascular abnormalities are linked to fall risk in older adults.
- Research on cardiovascular interventions for fall prevention is limited.
- Falls in older adults lead to significant morbidity, mortality, and healthcare costs.
Purpose of the Study:
- To conduct a scoping review of the literature on the effectiveness of cardiovascular evaluations and interventions in reducing fall risk in older people.
- To explore the current evidence base for cardiovascular interventions targeting fall prevention.
Main Methods:
- Systematic search of Medline, Cochrane Library, and WHO ICTRP.
- Inclusion of randomized controlled trials and intervention studies on community-dwelling adults aged ≥50 years.
- Assessment of study quality using Cochrane Checklist for risk of bias and ROBINS-I tool.
Main Results:
- Seven studies were included, with most showing a reduction in falls post-intervention.
- Pacemaker implantation for carotid sinus hypersensitivity (CSH) reduced falls in 2 out of 4 studies.
- Pacemaker implantation for sinus node dysfunction (SND) significantly reduced falls in both studies.
- One study reported a fall reduction from 100% to 33% after intervention.
Conclusions:
- Most studies indicate that cardiovascular evaluation and intervention can reduce fall rates in older adults.
- The current body of research on this topic is small, necessitating further investigation.
- Standardized cardiovascular risk assessment is crucial for fall prevention in the elderly, potentially reducing injuries and healthcare expenditures.
Objective:
Cardiovascular abnormalities are consistently associated with fall risk in older people. However, little research has been done to assess the effect of cardiovascular interventions on fall risk. The aim of this scoping review is to explore the current literature on the effectiveness of cardiovascular evaluations and interventions in reducing fall risk in older people.
Design:
Scoping review.
Data Sources:
Medline, Cochrane Library, and WHO ICTRP Search Portal were systematically searched.
Selection Criteria:
Randomized controlled trials (RCTs) and intervention studies of community-dwelling adults aged ≥50 years or with a mean age of >60 years that assessed the effect of a cardiovascular assessment and interventions in reducing fall risk. Key search concepts were "falls" and "aged", and terms for different cardiovascular evaluations and interventions were included. The Cochrane Checklist for risk of bias and the ROBINS-I tool were used to assess the quality of the studies.
Results:
Seven studies were included. The majority showed a reduction in falls after cardiovascular evaluation and intervention. Two out of four studies that focused on carotid sinus hypersensitivity (CSH) as a modifiable cardiovascular risk factor for falls, showed a significant reduction in falls after pacemaker implantation. Two studies that looked at sinus node dysfunction (SND) both showed a significant reduction in falls after pacemaker implantation. One study showed that 33% of the patients experienced a fall after cardiovascular evaluation and intervention, whereas all patients fell before assessment.
Conclusions:
The majority of the included studies showed a reduction in falls after the intervention. However, the number of published papers regarding the effect of cardiovascular assessment and interventions on falls is small. A standardized assessment of cardiovascular risk factors may be essential in preventing falls in older adults and could consequently reduce injuries, loss of quality of life, deaths, and fall-related expenditures.
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