Long-term cardiac monitoring in older adults with unexplained falls and syncope

Bhangu, Jaspreet; McMahon, Colm J.; Hall, Patricia; Bennett, Kathleen; Rice, Ciara; Crean, Peter; Sutton, Richard; Kenny, Rose Anne

doi:10.1136/heartjnl-2015-308706

Cited by 53 publications

(34 citation statements)

References 27 publications

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“…Observational studies also support the link between cardiovascular disease and NAF with higher rates of cardiac arrhythmia and carotid sinus syndrome in participants who report NAF[32, 33]. We have demonstrated that increasing cardiovascular co-morbidity were associated with an increase in reporting NAF adding to the evidence linking cardiovascular disease to NAF.…”

Section: Discussionsupporting

confidence: 70%

Falls, non-accidental falls and syncope in community-dwelling adults aged 50 years and older: Implications for cardiovascular assessment

et al. 2017

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ObjectivesTo calculate the prevalence of all falls, non-accidental falls and syncope in an older population and characterize cardiovascular risk profiles.DesignProspective, longitudinal cohort study.SettingThe first two waves of data from the Irish Longitudinal Study on Ageing (TILDA).Participants8172 community-dwelling adults aged 50 years and older resident in the Republic of IrelandMeasurementsSelf-reported history of all falls, non-accidental falls and syncope in the year preceding the first two waves of data collection. Demographic factors and self-reported cardiovascular conditions were used to characterize cardiovascular risk profiles.ResultsThe prevalence of all falls in the past year was 19.2% or 192 per thousand persons and increased with age (50–64 years 17.5%; 65–74 years 19.4%; 75+ years 24.4%). Non-accidental falls had an estimated prevalence of 5.1% or 51 falls per thousand persons and accounted for 26.5% of all falls reported and also increased with age (50–64 years 4.0%; 65–74 years 5.5%; 75+ years 8.0%). The prevalence for syncope was estimated to be 4.4% or 44per thousand persons but did not show a similar age gradient. Participants with at least 5 cardiovascular conditions were more likely to report all falls (OR = 2.07, 95% CI 1.18–3.64, p<0.05) and NAF (OR = 2.89, 95%CI 1.28–6.52, p<0.05).ConclusionsThe prevalence of all falls and non-accidental falls increases with age but the same pattern was not consistently observed for syncope. There is an increased odds of reporting all three outcomes with increasing number of self-reported cardiovascular conditions. Further work is needed to uncover the interplay between cardiovascular disease and subsequent falls.

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Section: Discussionsupporting

confidence: 70%

Falls, non-accidental falls and syncope in community-dwelling adults aged 50 years and older: Implications for cardiovascular assessment

et al. 2017

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“…This may explain the conflicting results of previous studies with the prevalence of UF varying from study to study. UF are often associated with CV events , and may be associated with orthostatic BP impairments either because an individual has amnesia for loss of consciousness coupled with unwitnessed syncopal events or because covert cerebral hypoperfusion causes balance instability and resultant falls . Repeated subclinical bouts of hypoperfusion in localized centers governing gait and balance, could lead to neurodegenerative changes and ultimately, impaired gait, balance, and UF .…”

Section: Discussionmentioning

confidence: 99%

Impaired Orthostatic Blood Pressure Recovery Is Associated with Unexplained and Injurious Falls

Finucane

O’Connell

Donoghue

et al. 2017

J American Geriatrics Society

118

108

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“…In addition, the first three waves of TILDA have already highlighted important issues surrounding health inequalities and the prevalence and underdiagnosis of some physical and mental health disorders (e.g., atrial fibrillation, obesity, hypertension, depression) in the older population. This research has helped, among other things, to inform a clinical trial on the monitoring of heart arrhythmias or atrial fibrillation (Bhangu et al, 2016). Such clinical trials provide a useful means by which research findings from observational studies may be translated and implemented in clinical practice.…”

Section: Health and Broader Economic Impactmentioning

confidence: 99%

“…Assessment tools have also been developed to identify older adults who are at risk for adverse outcomes (e.g., residential care, unplanned hospitalization) and, when fully implemented, will enable early interventions to target those most in need (Leahy-Warren et al, 2015). The Atlanticfunded audit of dementia care in acute care hospitals (Bhangu et al, 2016) revealed several areas of care that need to be improved, including assessment and discharge planning; these findings highlight the need to develop policies and care pathways to meet the complex needs of patients as well as providing baseline evidence from which to assess the effectiveness of any changes in practice. A recent grant supporting an extensive research program aimed at dementia prevention has the potential to help older adults maintain their cognitive health and independence (e.g., Hannigan, Coen, Lawlor, Robertson, & Brennan, 2015).…”

Section: Health and Broader Economic Impactmentioning

confidence: 99%

The Role of Philanthropic Funding in Building Research Evidence to Support an Aging Population: A Case Study from Ireland

Cochrane

McGilloway

2017

Journal of Aging & Social Policy

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This case study examines the role of philanthropic funding in building capacity for aging research in Ireland, and how this investment has addressed the lack of evidence to support planning for an aging population. The funding has supported a range of initiatives including the national longitudinal study on aging (TILDA), the creation of three professorships/chairs, and the establishment of four new research centers. Important potential outcomes are emerging across other domains including research-informed policy development and the generation of health benefits. The efforts of academic researchers to ensure that their findings are readily accessible to end users and to forge robust working relationships with all stakeholders have helped to enhance the use of research findings. Overall, philanthropy has played a pivotal role in building capacity, infrastructure, and expertise in academic settings in Ireland. Moreover, this work provides an excellent example of how such efforts can begin to inform effective planning and service provision.

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Long-term cardiac monitoring in older adults with unexplained falls and syncope

Cited by 53 publications

References 27 publications

Falls, non-accidental falls and syncope in community-dwelling adults aged 50 years and older: Implications for cardiovascular assessment

Falls, non-accidental falls and syncope in community-dwelling adults aged 50 years and older: Implications for cardiovascular assessment

Impaired Orthostatic Blood Pressure Recovery Is Associated with Unexplained and Injurious Falls

The Role of Philanthropic Funding in Building Research Evidence to Support an Aging Population: A Case Study from Ireland

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