Orthostatic hypotension does not predict recurrent falling in a nursing home population.
OBJECTIVE
Most studies regard orthostatic hypotension (OH) as a causal factor for falls. However, the evidence is lacking for this assumption. We aimed to investigate the relationship between orthostatic hypotension and fall incidents in nursing home residents.


METHODS
A total of 249 patients was included in a prospective observational cohort study of nursing home residents. Falls were prospectively registered. Cox proportional hazard modelling and the conditional frailty model were used to analyse the relationship between OH and (recurrent) falling.


RESULTS
Among the 249 patients, 450 falls were recorded during follow-up and OH was present in 93 out of 249 patients. No significant associations were found between OH and the first fall incident (Hazard Ratio (HR) 1.01 (95% Confidence Interval (CI) 0.60-1.69) and recurrent falling (HR 1.21 (95%CI 0.65-2.24)).


CONCLUSIONS
Although falling and OH were both highly prevalent in nursing home residents, no relationship between OH and falling was found.
Diabetes Centre, Isala, P.O. Box 10400, 8000 G.K. Zwolle, The Netherlands. Electronic address: l.c.hartog@isala.nl.
L C
LC
Hartog
TriviumMeulenbeltZorg, PC Borstlaan 10, 7555 SH Hengelo, The Netherlands. Electronic address: MCimzar-Sweelssen@triviummeulenbeltzorg.nl.
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M
Cimzar-Sweelssen
TriviumMeulenbeltZorg, PC Borstlaan 10, 7555 SH Hengelo, The Netherlands. Electronic address: AKnipscheer@triviummeulenbeltzorg.nl.
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A
Knipscheer
Diabetes Centre, Isala, P.O. Box 10400, 8000 G.K. Zwolle, The Netherlands; University Medical Centre Groningen and University of Groningen, Department of General Practice, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands. Electronic address: k.h.groenier@umcg.nl.
K H
KH
Groenier
Diabetes Centre, Isala, P.O. Box 10400, 8000 G.K. Zwolle, The Netherlands; Langerhans Medical Research Group, P.O. Box 10400, 8000 G.K. Zwolle, The Netherlands. Electronic address: n.kleefstra@isala.nl.
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Kleefstra
Diabetes Centre, Isala, P.O. Box 10400, 8000 G.K. Zwolle, The Netherlands; University Medical Centre Groningen and University of Groningen, Department of Internal Medicine, Hanzeplein 1, 9700 RB Groningen, The Netherlands; Isala, Department of Internal Medicine, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands. Electronic address: H.J.G.Bilo@isala.nl.
H J G
HJ
Bilo
Langerhans Medical Research Group, P.O. Box 10400, 8000 G.K. Zwolle, The Netherlands. Electronic address: k.j.j.van.hateren@isala.nl.
K J J
KJ
van Hateren
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000453:epidemiology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes; D016016:Proportional Hazards Models; D012008:Recurrence
Fall risk; Nursing home residents; Orthostatic hypotension; Recurrent falling