Cerebral hypoperfusion and future falls risk among community dwelling older adults with orthostatic hypotension.
Background Falls are a major health concern for older adults, affecting one-third of those over 65 years annually, with 10%–20% leading to injury or hospitalisation. Whilst falls are often multifactorial, unexplained falls may overlap with syncope. Orthostatic hypotension (OH), characterised by a si...
| Publicado en: | Age & Ageing Vol. 55; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jan2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513120&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513120 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jan2026 vid: 55 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513120 10.1093/ageing/afaf379 ppf: 1 ppct: 9 formats: tig: atl: Cerebral hypoperfusion and future falls risk among community dwelling older adults with orthostatic hypotension. aug: au: Claffey, Paul Pérez-Denia, Laura Newman, Louise Finucane, Ciarán Kenny, Rose Anne Briggs, Robert affil: Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, IrelandDepartment of Medical Gerontology, School of Medicine, University of Dublin Trinity College, IrelandThe Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, IrelandDepartment of Medical Gerontology, School of Medicine, University of Dublin Trinity College, Ireland The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland Department of Medical Gerontology, School of Medicine, University of Dublin Trinity College, IrelandDepartment of Medical Physics and Bioengineering, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland su: Cross-sectional method Old age Risk assessment Independent living Center for Epidemiologic Studies Depression Scale Research funding Logistic regression analysis Questionnaires Descriptive statistics Longitudinal method Odds ratio Cerebral cortex Orthostatic hypotension Cerebral circulation Cerebral anoxia Blood pressure Confidence intervals Data analysis software Accidental falls Regression analysis Disease complications sug: subj: Cross-sectional method Old age Risk assessment Independent living Center for Epidemiologic Studies Depression Scale Research funding Logistic regression analysis Questionnaires Descriptive statistics Longitudinal method Odds ratio Cerebral cortex Orthostatic hypotension Cerebral circulation Cerebral anoxia Blood pressure Confidence intervals Data analysis software Accidental falls Regression analysis Disease complications keyword: alveolar ventilation function brain cell respiration cerebral hypoperfusion cerebral perfusion community copyrightHolder:British Geriatrics Society copyrightYear:2026 falls frontal lobe https://dx.doi.org/10.1093/ageing/afaf379 inLanguage:en near-infrared older adult older people orthostatic hypotension publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41579034/ spectroscopy alveolar ventilation function brain cell respiration cerebral hypoperfusion cerebral perfusion community copyrightHolder:British Geriatrics Society copyrightYear:2026 falls frontal lobe https://dx.doi.org/10.1093/ageing/afaf379 inLanguage:en near-infrared older adult older people orthostatic hypotension publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41579034/ spectroscopy ab: Background Falls are a major health concern for older adults, affecting one-third of those over 65 years annually, with 10%–20% leading to injury or hospitalisation. Whilst falls are often multifactorial, unexplained falls may overlap with syncope. Orthostatic hypotension (OH), characterised by a significant drop in blood pressure (BP) upon standing, is a potent falls risk factor, likely due to cerebral hypoperfusion. While the association between OH and falls is well established, few studies have examined the combined role of OH and real-time cerebral perfusion measures in predicting future unexplained falls. Methods Frontal lobe cerebral oxygenation (Tissue Saturation Index, TSI) was measured using near-infrared spectroscopy alongside continuous beat-to-beat BP monitoring (Finometer) during active standing in 2478 participants (≥55 years) from Wave 3 of The Irish Longitudinal Study on Ageing. OH was defined as a sustained SBP drop ≥20 mmHg and/or DBP drop ≥10 mmHg at 30, 60 or 90 seconds post-standing. A TSI drop ≥75th centile at 30 seconds was classified as 'greater TSI drop.' Associations between TSI change and OH were analysed using multilevel mixed-effects regression, and longitudinal relationships with unexplained falls were assessed over four years. Results One-fifth of participants had OH, associated with older age and cardiovascular disease. OH was associated with significantly greater TSI change from baseline at 30, 60 and 90 seconds (p < .001) in adjusted models. The combination of OH and greater TSI drops predicted future unexplained falls (OR 2.16, p = .003), whereas OH and lower TSI drops did not (OR 1.25, p = .288). Conclusion The risk of falls associated with OH appears to be modified by the extent of cerebral hypoperfusion upon standing. These findings suggest that integrating cerebral perfusion measures with OH assessment may help refine risk stratification in older adults, particularly for unexplained falls. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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