title: High arterial pulse wave velocity is a risk factor for falls in community-dwelling older people.
abstract: OBJECTIVE
  To examine whether arterial stiffness is a risk factor for falls in community-dwelling older people.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Community population, Sydney, Australia.
  
  
  METHODS
  Community-dwelling older adults (mean age 79.8±4.4, 52.2% female; N=481).
  
  
  METHODS
  Carotid-femoral pulse wave velocity (PWV) was measured in the supine position after lying for 10 minutes. Demographic, medical, and medication characteristics and levels of physical activity were obtained in clinical interviews and questionnaires, and falls were recorded with monthly falls diaries for 12 months.
  
  
  RESULTS
  Participants in the top quintile of PWV (high PWV) were more likely to have higher seated systolic blood pressure (SBP) and heart rate, unsatisfactory control of blood pressure, diabetes mellitus, and lower physical activity levels. These participants were also more likely to be male and taking cardiovascular medications. Of the 473 participants available for follow-up, 212 (44.8%) reported one or more falls. In modified Poisson regression analyses, high PWV was a risk factor for falls (relative risk=1.37, 95% confidence interval=1.06-1.78) after adjusting for use of psychotropic and cardiovascular medications, age, sex, body mass index, seated SBP, heart rate, and diabetes status.
  
  
  CONCLUSIONS
  In community-dwelling older people, high PWV (as a measure of arterial stiffness) was a risk factor for falls after adjusting for potential demographic, anthropometric, disease, and medication confounders. Further research is required to investigate mediators for this association and the effect of lowering arterial stiffness on falls in older people.
authors.affiliation: Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Alfred K W
authors.initials: AK
authors.lastname: Wong
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Julian N
authors.initials: JN
authors.lastname: Trollor
authors.forename: Daina L
authors.initials: DL
authors.lastname: Sturnieks
authors.forename: Kim
authors.initials: K
authors.lastname: Delbaere
authors.forename: Jasmine
authors.initials: J
authors.lastname: Menant
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Perminder S
authors.initials: PS
authors.lastname: Sachdev
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D002339:Carotid Arteries / Q000502:physiology; D005260:Female; D005263:Femoral Artery / Q000502:physiology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D059289:Vascular Stiffness / Q000502:physiology*
keywords: accidental falls; aged; arterial stiffness; psychotropic medications; pulse wave velocity