TY - JOUR
T1 - The impact of cardiovascular diagnostics and treatments on fall risk in older adults
T2 - a scoping review and evidence map
AU - Pronk, Anouschka C.
AU - Wang, Liping
AU - van Poelgeest, Eveline P.
AU - Leeflang, Mariska M. G.
AU - Daams, Joost G.
AU - Hoekstra, Alfons G.
AU - van der Velde, Nathalie
N1 - Funding Information: This work was supported by the University of Amsterdam, Clementine Brigitta Maria Dalderup fund (grant number 3021 and 3549), and the China Scholarship Council (grant number 202007720083). The funding institutions had no influence on any part of this manuscript. Publisher Copyright: © 2023, The Author(s).
PY - 2024/4
Y1 - 2024/4
N2 - Background: We aimed to summarize the published evidence on the fall risk reducing potential of cardiovascular diagnostics and treatments in older adults. Methods: Design: scoping review and evidence map. Data sources: Medline and Embase. Eligibility criteria: all available published evidence; Key search concepts: “older adults,” “cardiovascular evaluation,” “cardiovascular intervention,” and “falls.” Studies reporting on fall risk reducing effect of the diagnostic/treatment were included in the evidence map. Studies that investigated cardiovascular diagnostics or treatments within the context of falls, but without reporting a fall-related outcome, were included in the scoping review for qualitative synthesis. Results: Two articles on cardiovascular diagnostics and eight articles on cardiovascular treatments were included in the evidence map. Six out of ten studies concerned pacemaker intervention of which one meta-analyses that included randomized controlled trials with contradictory results. A combined cardiovascular assessment/evaluation (one study) and pharmacotherapy in orthostatic hypotension (one study) showed fall reducing potential. The scoping review contained 40 articles on cardiovascular diagnostics and one on cardiovascular treatments. It provides an extensive overview of several diagnostics (e.g., orthostatic blood pressure measurements, heart rhythm assessment) useful in fall prevention. Also, diagnostics were identified, that could potentially provide added value in fall prevention (e.g., blood pressure variability and head turning). Conclusion: Although the majority of studies showed a reduction in falls after the intervention, the total amount of evidence regarding the effect of cardiovascular diagnostics/treatments on falls is small. Our findings can be used to optimize fall prevention strategies and develop an evidence-based fall prevention care pathway. Adhering to the World guidelines on fall prevention recommendations, it is crucial to undertake a standardized assessment of cardiovascular risk factors, followed by supplementary testing and corresponding interventions, as effective components of fall prevention strategies. In addition, accompanying diagnostics such as blood pressure variability and head turning can be of added value.
AB - Background: We aimed to summarize the published evidence on the fall risk reducing potential of cardiovascular diagnostics and treatments in older adults. Methods: Design: scoping review and evidence map. Data sources: Medline and Embase. Eligibility criteria: all available published evidence; Key search concepts: “older adults,” “cardiovascular evaluation,” “cardiovascular intervention,” and “falls.” Studies reporting on fall risk reducing effect of the diagnostic/treatment were included in the evidence map. Studies that investigated cardiovascular diagnostics or treatments within the context of falls, but without reporting a fall-related outcome, were included in the scoping review for qualitative synthesis. Results: Two articles on cardiovascular diagnostics and eight articles on cardiovascular treatments were included in the evidence map. Six out of ten studies concerned pacemaker intervention of which one meta-analyses that included randomized controlled trials with contradictory results. A combined cardiovascular assessment/evaluation (one study) and pharmacotherapy in orthostatic hypotension (one study) showed fall reducing potential. The scoping review contained 40 articles on cardiovascular diagnostics and one on cardiovascular treatments. It provides an extensive overview of several diagnostics (e.g., orthostatic blood pressure measurements, heart rhythm assessment) useful in fall prevention. Also, diagnostics were identified, that could potentially provide added value in fall prevention (e.g., blood pressure variability and head turning). Conclusion: Although the majority of studies showed a reduction in falls after the intervention, the total amount of evidence regarding the effect of cardiovascular diagnostics/treatments on falls is small. Our findings can be used to optimize fall prevention strategies and develop an evidence-based fall prevention care pathway. Adhering to the World guidelines on fall prevention recommendations, it is crucial to undertake a standardized assessment of cardiovascular risk factors, followed by supplementary testing and corresponding interventions, as effective components of fall prevention strategies. In addition, accompanying diagnostics such as blood pressure variability and head turning can be of added value.
KW - Cardiovascular
KW - Evidence map
KW - Fall prevention
KW - Intervention
KW - Older adults
KW - Scoping review
UR - http://www.scopus.com/inward/record.url?scp=85174616253&partnerID=8YFLogxK
UR - https://pure.uva.nl/ws/files/161687892/Supplementary_Information-The_impact_of_cardiovascular_diagnostics_and_treatments_on_fall_risk_in_older_adults.pdf
U2 - 10.1007/s11357-023-00974-4
DO - 10.1007/s11357-023-00974-4
M3 - Review article
C2 - 37864713
SN - 2509-2715
VL - 46
SP - 153
EP - 169
JO - GeroScience
JF - GeroScience
ER -