@article{ref1,
title="A prospective study of the association between orthostatic hypotension and falls: definition matters",
journal="Age and ageing",
year="2016",
author="McDonald, Claire and Pearce, Mark and Kerr, Simon R. and Newton, Julia",
volume="46",
number="3",
pages="439-445",
abstract="BACKGROUND: falls are a common cause of morbidity and mortality in older people. Orthostatic hypotension (OH) is considered an important risk factor for falls, but longitudinal studies have failed to show a clear association. This disparity may be because conventional methods of measuring blood pressure (BP) changes are too imprecise and/or the diagnostic criteria for OH are inappropriate. Over recent years, beat-to-beat BP monitoring techniques, which enabled accurate measurement of vasodepression, have become widely used and in 2011 the American Academy of Neurology produced revised diagnostic criteria for OH. <br><br>OBJECTIVE: to use beat-to-beat monitoring to compare the prevalence of OH using the standard and revised diagnostic criteria and to establish which criteria are most valuable in predicting future falls. <br><br>DESIGN: two hundred and ninety-seven community-dwelling older people aged ≥65 years underwent assessment. Active stand using digital photoplethysmography was used to record postural change in BP. One hundred participants were asked to complete prospective weekly falls diaries for 12 months. <br><br>RESULTS: OH, defined according to the revised American Academy of Neurology diagnostic criteria, affected 25% of participants and was an independent predictor of falls (odds ratio 10.299, 95% confidence interval [95% CI]: 1.703-61.43, P = 0.011) and time to first fall (hazard ratio 3.017, 95% CI: 1.291-7.050, P = 0.011). OH, defined according to standard criteria, affected 80% of the population and was not associated with falls. <br><br>CONCLUSION: OH, defined according to 2011 criteria, is associated with falls and time to first fall. These findings indicate that beat-to-beat monitoring and the 2011 criteria for OH are valuable in the clinical assessment of older fallers.<br><br>© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.<p /> <p>Language: en</p>",
language="en",
issn="0002-0729",
doi="10.1093/ageing/afw227",
url="http://dx.doi.org/10.1093/ageing/afw227"
}