Cardiovascular Disorders and Falls Among Older Adults: A Systematic Review and Meta-Analysis

医学 优势比 内科学 观察研究 冲程(发动机) 荟萃分析 心房颤动 冠状动脉疾病 动脉硬化 物理疗法 置信区间 心脏病学 血压 机械工程 工程类
作者
Robbie Bourke,Paul Doody,Sergio Pérez,David Moloney,Lewis A. Lipsitz,Rose Anne Kenny
出处
期刊:The Journals of Gerontology [Oxford University Press]
卷期号:79 (2) 被引量:16
标识
DOI:10.1093/gerona/glad221
摘要

Abstract Background Falls are a common cause of injury, hospitalization, functional decline, and residential care admission among older adults. Cardiovascular disorders are recognized risk factors for falls. This systematic review assesses the association between cardiovascular disorders and falls in older adults. Methods Systematic searches were conducted on MEDLINE and Embase, encompassing all literature published prior to December 31, 2022. Included studies addressed persons aged 50 years and older, and assessed the association between cardiovascular disorders and falls or the efficacy of cardiovascular-based interventions to reduce falls. Two reviewers independently extracted data and assessed study quality utilizing a modified Newcastle–Ottawa scale for observational studies, and the Cochrane Risk of Bias 2 tool for interventional studies. A systematic narrative analysis of all cardiovascular outcomes, and meta-analyses of unadjusted odds ratios (ORs) were performed. Results One hundred and eighty-four studies were included: 181 observational and 3 interventional. Several cardiovascular disorders, including stroke, coronary artery disease, valvular heart disease, arterial stiffness, arrhythmia, orthostatic hypotension, and carotid sinus hypersensitivity, were consistently associated with falls. In meta-analysis of unadjusted ORs, the largest positive pooled associations with falls during a 12-month reporting interval were for stroke (OR: 1.90, 95% confidence interval [CI]: 1.70–2.11), peripheral arterial disease (OR: 1.82, 95% CI: 1.12–2.95), atrial fibrillation (OR: 1.52, 95% CI: 1.27–1.82), and orthostatic hypotension (OR: 1.39, 95% CI: 1.18–1.64). Conclusions Several cardiovascular disorders are associated with falls. These results suggest the need to incorporate cardiovascular assessments for patients with falls. This review informed the cardiovascular recommendations in the new World Guidelines for falls in older adults. Clinical Trials Registration Number: CRD42021272245
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