Postprandial hypotension (PPH), a fall in systolic blood pressure (SBP) within 2 h of a meal, may detrimentally affect gait parameters and increase the falls risk in older people. We aimed to determine the effects of postprandial SBP on heart rate (HR), gait speed, and stride length, double-support time and swing time variability in older subjects with and without PPH. Twenty-nine subjects were studied on three days: glucose (“G”), water and walk (“WW”), glucose and walk (“GW”). Subjects consumed a glucose drink on “G” and “GW” and water on “WW”. The “G” day determined which subjects had PPH. On “WW” and “GW” gait was analyzed. Sixteen subjects demonstrated PPH. In this group, there were significant changes in gait speed (p = 0.040) on “WW” and double-support time variability (p = 0.027) on “GW”. The area under the curve for the change in gait parameters from baseline was not significant on any study day. Among subjects without PPH, SBP increased on “WW” (p < 0.005) and all gait parameters remained unchanged on all study days. These findings suggest that by changing gait parameters, PPH may contribute to an increased falls risk in the older person with PPH.
Aim: To determine in older hospitalized patients the prevalence of neck of femur (NOF) fractures occurring within two hours of a meal and the factors associated with these fractures.
Methods:A prospective study was undertaken within the orthopedic unit of a 320 bed general hospital. Consecutive first admissions of patients aged 70 years and over with fragility NOF fractures between March and November 2011 were included. Patients or their careers were interviewed using a standardised questionnaire.Results: 120 patients were recruited. The median age was 84.0 years. Falls within two hours of a meal occurred in 20.8% of patients. Independent factors associated with falls occurring within two hours of a meal were symptoms of hypotension prior to a fall (OR 5.2, CI 1.342-20.129; P=0.017) and being in residential care (OR 3.0, CI 1.009-8.687; P=0.048).
Conclusion:Patients who sustained a NOF fracture within two hours of a meal were more likely to be from residential care and experience symptoms associated with hypotension before the fall compared with patients who experienced a fall after two hours of a meal; identification of the reasons for hypotension and potential management strategies require further investigation.
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