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Journal Article


Kitzman DW, Upadhya B, Duncan P. J. Am. Geriatr. Soc. 2019; 67(9): 1774-1776.


Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina.


(Copyright © 2019, John Wiley and Sons)






Our former chief of cardiology had just completed a routine annual examination on a robust 95‐year‐old entrepreneur who still personally ran his own large, sprawling business. After declaring him to be still free of any cardiovascular disease, the cardiologist asked his patient, “What is your key to long life and being so healthy and successful at your advanced age?” His usually jovial patient turned serious, lowered his voice, pointed a finger to his questioner's nose and said emphatically, “Don't fall!” The patient went on to explain that for nearly every one of his friends and family who had died, and there had now been many, their demise began with a fall. “Worst thing that can happen to an old person,” he said.

The cardiology chief then asked his patient to please explain to him why he insists on seeing a cardiologist each year despite never having had a heart attack or other cardiovascular event. “That's one of the reasons I don't have falls. The heart, the arteries, I take good care of them. I want your help to continue doing that.” Perhaps the nonagenarian was channeling the 17‐th century physician Thomas Sydenham, who famously quipped, “A man is as old as his arteries.”

A report in the current issue of the journal supports this nonagenarian's theory. Falls are much more frequent in older persons, and when they occur in older persons, falls are associated with marked morbidity and mortality. It was already known that patients with established (overt) cardiovascular disease have more frequent falls, more serious falls, and relatively poorer outcomes. However, it is not been known whether subclinical cardiovascular disease was also associated with a greater risk of falls. Juraschek and colleagues significantly extended our understanding of the relationship between cardiovascular disease and falls in older patients by examining ...

Language: en


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