Chen-Ying Hung1, Tsu-Juey Wu2, Kuo-Yang Wang3, Jin-Long Huang2, El-Wui Loh4, Yi-Ming Chen5, Chu-Sheng Lin6, Ching-Heng Lin7, Der-Yuan Chen8, Yih-Jing Tang9. 1. Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; 2. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan; ; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 3. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 4. Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; 5. Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; National Yang-Ming University, Taipei, Taiwan; 6. Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; 7. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan; 8. Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; National Yang-Ming University, Taipei, Taiwan; ; National Chung-Hsing University, Taichung, Taiwan. 9. Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; School of Medicine, Chung Shan Medical University, Taichung, Taiwan;
Abstract
BACKGROUND: Atrial fibrillation is a common heart rhythm disorder in older adults, and its prevalence has increased rapidly in recent years. The health issues associated with atrial fibrillation are not limited to physiological problems, as it also contributes to an increased risk of falls, which may be related to cardiovascular co-morbidities and medication use. The aim of this study was to determine which cardiovascular co-morbidities and medication use are associated with falls in older adults with atrial fibrillation. METHODS: Four hundred and one patients 75 years of age or older (82.2 ± 0.2 years) were enrolled in a geriatric evaluation and management unit in Taiwan. Events associated with patient falls and medication use were recorded, and comprehensive geriatric assessment was conducted during admission. RESULTS: Among the study participants, 66 (16.5%) patients had atrial fibrillation and 234 (58.4%) patients had a history of fall. We found a significantly higher prevalence of falls in patients with atrial fibrillation [odds ration (OR) 1.98, 95% confidence interval (CI) 1.08-3.63, p = 0.026] compared with those without atrial fibrillation. Using multivariate logistic regression, we found that benzodiazepine use (OR 18.22, 95% CI 2.71-122.38, p = 0.003), a history of paroxysmal atrial fibrillation (OR 12.18, 95% CI 1.37-108.70, p = 0.025) and hypertension (OR 9.49, 95% CI 1.19-75.57, p = 0.034) were independent factors for falls in atrial fibrillation patients. CONCLUSIONS: A diagnosis of atrial fibrillation in elderly patients is associated with falls. Benzodiazepine use, history of paroxysmal atrial fibrillation, and hypertension were associated with a high falling prevalence among patients with atrial fibrillation. KEY WORDS: Atrial fibrillation; Benzodiazepine; Falls; Hypertension.
BACKGROUND:Atrial fibrillation is a common heart rhythm disorder in older adults, and its prevalence has increased rapidly in recent years. The health issues associated with atrial fibrillation are not limited to physiological problems, as it also contributes to an increased risk of falls, which may be related to cardiovascular co-morbidities and medication use. The aim of this study was to determine which cardiovascular co-morbidities and medication use are associated with falls in older adults with atrial fibrillation. METHODS: Four hundred and one patients 75 years of age or older (82.2 ± 0.2 years) were enrolled in a geriatric evaluation and management unit in Taiwan. Events associated with patientfalls and medication use were recorded, and comprehensive geriatric assessment was conducted during admission. RESULTS: Among the study participants, 66 (16.5%) patients had atrial fibrillation and 234 (58.4%) patients had a history of fall. We found a significantly higher prevalence of falls in patients with atrial fibrillation [odds ration (OR) 1.98, 95% confidence interval (CI) 1.08-3.63, p = 0.026] compared with those without atrial fibrillation. Using multivariate logistic regression, we found that benzodiazepine use (OR 18.22, 95% CI 2.71-122.38, p = 0.003), a history of paroxysmal atrial fibrillation (OR 12.18, 95% CI 1.37-108.70, p = 0.025) and hypertension (OR 9.49, 95% CI 1.19-75.57, p = 0.034) were independent factors for falls in atrial fibrillationpatients. CONCLUSIONS: A diagnosis of atrial fibrillation in elderly patients is associated with falls. Benzodiazepine use, history of paroxysmal atrial fibrillation, and hypertension were associated with a high falling prevalence among patients with atrial fibrillation. KEY WORDS: Atrial fibrillation; Benzodiazepine; Falls; Hypertension.
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