Falls and Atrial Fibrillation in Elderly Patients.
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.


BACKGROUND
Atrial fibrillation; Benzodiazepine; Falls; Hypertension.
Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan;
Chen-Ying
CY
Hung
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;
Tsu-Juey
TJ
Wu
Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; School of Medicine, Chung Shan Medical University, Taichung, Taiwan;
Kuo-Yang
KY
Wang
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;
Jin-Long
JL
Huang
Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan;
El-Wui
el-W
Loh
Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; National Yang-Ming University, Taipei, Taiwan;
Yi-Ming
YM
Chen
Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan;
Chu-Sheng
CS
Lin
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan;
Ching-Heng
CH
Lin
Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; National Yang-Ming University, Taipei, Taiwan; ; National Chung-Hsing University, Taichung, Taiwan.
Der-Yuan
DY
Chen
Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan; ; School of Medicine, Chung Shan Medical University, Taichung, Taiwan;
Yih-Jing
YJ
Tang