New research may partly explain why many older people fall–aside from trips, slips, drunkenness, and medical troubles such as epilepsy and stroke. According to a new study published in the November 1 issue of the Journal of the American College of Cardiology, an undiagnosed heart problem could be to blame.
“We found that in older people with nonaccidental falls, one in five had carotid sinus syndrome,” says study author Rose Ann M. Kenny, MD, professor of cardiovascular research at the Newcastle Institute for Aging and Health at the University of Newcastle in the United Kingdom.
Carotid sinus syndrome causes a person’s heart rate to slow down to the point that not enough blood goes to their brain. People with this condition typically faint.
To figure out whether this type of fainting was causing falls, Kenny and colleagues firmly massaged the carotid arteries (neck glands) of emergency room patients over 50 years old. Patients who experienced significantly slower heart rates during the massage were diagnosed as having carotid sinus syndrome. Of the 175 people who had the syndrome, half received pacemaker implants to regulate their heartbeats, and the other half received standard treatment (observation and/or medication). All participants were asked to keep a written record of falls and other problems.
After 1 year, researchers found the pacemaker group experienced two-thirds fewer falls and 70% fewer injuries compared to the other group.
The finding shows that some patients fall because of an abnormal heartbeat, says Kenny. She also says the results suggest that some older people may be helped by seeing a cardiologist after experiencing an unexplained, nonaccidental fall.
J. H. McAnulty, MD, a physician at Oregon Health & Science University, calls the study a “landmark” investigation. “They’re on to something here,” he says, noting that the study is a good reminder for doctors to explore abnormal heart rhythms as a possible explanation for nonaccidental falls. Yet he says it’s too early to make specific clinical recommendations.
In an editorial also published in the November 1 issue of the Journal of the American College of Cardiology, McAnulty points out that researchers did not account for other gait or medical troubles that could explain some falls. Plus, he says the study was too small, and more research needs to be done before doctors could definitively recommend pacemakers to patients with carotid sinus syndrome.
In the meantime, Kenny suggests that it might not hurt to see a heart doctor for unexplained falls. “You should ask the cardiologist about heart rhythm during carotid sinus pressure.”
Article By: Dulce Zamora, Medical Writer