Citation

Arita T, Suzuki S, Yagi N, Otsuka T, Semba H, Kano H, Matsuno S, Kato Y, Uejima T, Oikawa Y, Matsuhama M, Yajima J, Yamashita T. J. Am. Med. Dir. Assoc. 2019; 20(6): 765-769.

Affiliation

Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1016/j.jamda.2018.10.008

PMID

30470574

Abstract

OBJECTIVES: Several studies have suggested a possible relationship between atrial fibrillation (AF) and falls. However, whether the relationship depends on AF types is unclear. We investigated the relationship between sustaining AF and falls.

DESIGN: Single hospital-based cohort study with a follow-up of falls within 3 years after baseline. SETTING AND PARTICIPANTS: A total of 14,056 patients from our cohort between February 2010 and March 2016. MEASURES: Incidence of falls within 3 years by baseline cardiac rhythm was measured, and we investigated the effects of AF types on incidence of falls.

RESULTS: The study population was divided into younger (<75 years old; n = 11,808) and older (≥75 years old; n = 2248) groups, and then divided into 3 groups according to the baseline cardiac rhythm: sinus rhythm (SR), paroxysmal AF (PAF), and persistent AF (PeAF). There were more male patients in the PeAF group; these patients had more comorbidities both in the younger and older groups. The cumulative incidence rates of falls at 1 year in patients with SR, PAF, and PeAF were similar in the younger group (0.4%, 0.4%, and 0.6%, respectively; P =.496), whereas those were significantly different in the older group (2.3%, 2.7%, and 5.0%, respectively; P = .024). In multivariate analysis, both PAF [hazard ratio (HR) 1.179; 95% confidence interval (CI) 0.553-2.511, reference SR] and PeAF (HR 1.502; 95% CI 0.635-3.556) were not associated with falls in the younger group. In the older group, PeAF was independently associated with incidence of falls (HR 2.257; 95% CI 1.262-4.037), but PAF was not (HR 1.317; 95% CI 0.673-2.574).

CONCLUSIONS/IMPLICATIONS: PeAF, not PAF, was associated independently with falls in older patients, suggesting the possible effect of irregular beats on physical frailty in the older population.

Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Atrial fibrillation; falls; incidence; risk factors