Falling: is the heart to blame?
Sofie Jansen is a research fellow at the department of Geriatric Medicine in the Academic Medical Center in Amsterdam, the Netherlands. Her PhD focusses on the contribution of cardiovascular diseases to falls in older adults. Last year she spent six months as a visiting researcher in Trinity College, Dublin. In 2015 she will start her training as a Medical & Geriatrics Registrar. In this blog she comments on her recent publication in Age and Ageing journal.
People often consider falling to be an unavoidable consequence of old age – we’ve all heard stories of a grandmother or elderly aunt who has taken a tumble. As such, falls are often accepted as a fact of life by older persons and those who care for them. But is this really the case? There are a number of factors that individually, or in combination, can contribute to people falling: balance problems, poor vision, the side-effects of medication. Most of these factors can be treated or targeted, leading to a reduction in falls. Recognition of these treatable risk factors is therefore important.
Recent studies also show that falls have frequent overlap with faints and blackouts (syncope), caused by heart conditions or blood pressure problems. But because older adults who fall don’t always know that they’ve lost consciousness, and there aren’t often any eye-witnesses, it can be difficult to delineate between a faint (caused by cardiovascular issues) and a fall. This led us to investigate whether certain heart conditions are related to falls, faints and blackouts. Using data from The Irish Longitudinal Study on Ageing - Ireland’s largest study of the general population – we hoped to add to the knowledge that would help manage and reduce the risk of falls in older people.
We asked participants in the study how often they had fallen or experienced a faint or blackout in the past year. They were also asked whether a doctor had ever told them they suffered from a heart condition. Those who reported falls or faints were more likely to suffer from heart problems (abnormal heart rhythm, heart murmur, heart failure, angina or a previous heart attack) than those who hadn’t fallen. And that likelihood grew stronger for those who fell or fainted more than once in the past year.
The results indicate that older adults who fall or faint are at higher risk of having certain heart conditions, especially those who fall or faint multiple times. We believe that doctors and other health care professionals should therefore consider these heart conditions as a potential factor when examining older adults who present with falls and faints. From here, the next step is to determine whether treatment of these heart conditions could also reduce the risk of falls and the subsequent, sometimes even catastrophic, effects on older people.