期刊
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
卷 64, 期 5, 页码 1073-1078出版社
WILEY
DOI: 10.1111/jgs.14104
关键词
accidental falls; aged; unexplained falls; orthostatic hypotension; depression
资金
- National Health and Medical Research Council (NHMRC) of Australia [510110]
- NHMRC [350833]
- Prince of Wales Clinical School, University of New South Wales
ObjectivesTo investigate risk factors for unexplained falls in older community-dwelling individuals. DesignProspective cohort study. SettingCommunity population, Sydney, Australia. ParticipantsOlder adults (N=529; mean age 79.84.4, 52.2% female). MeasurementsParticipants provided information demographic, medical, and medication characteristics and completed cardiovascular (tilt table test, pulse wave velocity), cognitive, and sensorimotor assessments at baseline. Falls were then recorded in monthly fall diaries for 12months. Unexplained fallers (UFs) were those who reported falls due to a blackout, dizziness, feeling faint, or found themselves suddenly on the ground. ResultsOf the 523 participants available at follow-up, 238 (45.5%) reported one or more falls; 35 participants fulfilled the definition of UFs. UFs were more likely than balance-related fallers (BFs) (n=203) and nonfallers (n=291) to have orthostatic hypotension (39.4%, 20.5% and 22.4%, respectively) and depressive symptoms (24.2%, 10.1%, and 7.9% respectively). More UFs (88.6%) than BFs (70.9%) had injurious falls. A multivariate logistic regression model revealed that depressive symptoms and orthostatic hypotension were significant and independent determinants of UF status. ConclusionApproximately 15% of fallers had unexplained falls, which were more likely to result in injuries. Depressive symptoms and orthostatic hypotension increased the risk of unexplained falls, whereas cognitive deficits and sensorimotor and balance impairments did not. Future research should investigate whether psychotherapy and physical exercise to improve mood and medication reviews and nonpharmacological therapies for the treatment of orthostatic hypotension and depression are effective at reducing the risk of unexplained falls in older people.
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