7 December 2001 News Update

REDUCING FALLS BY THE ELDERLY

Elderly adults who have recurrent falls usually attributed to old age or weak joints may actually suffer from a heart condition that can be effectively treated by cardiac pacing.

A UK study by Newcastle University's Professor Rose Anne Kenny indicates that unexplained falls in the elderly may be the result of a condition called carotid sinus syndrome (CSS) which results in fainting.

CSS in the elderly is manifested by extremely slow heart rates and abnormally low blood pressure. A specific type of CSS, known as cardioinhibitory, is characterised by a stoppage of the heartbeat when pressure is applied or sensed near the carotid artery in the neck. People with this tendency are at higher risk of falls.

Professor Kenny believes that patients with this syndrome could benefit from dual-chamber pacing which has been proved to reduce falls and associated injuries by 70 per cent, and fainting episodes by 50 per cent.

The findings follow a study of 175 United Kingdom patients participating in a study. ``It clearly indicates that for patients with non-accidental falls and cardioinhibitory CSS, cardiac pacing significantly reduces subsequent falls,'' said Professor Kenny. ``No other single intervention for falls has demonstrated this magnitude of benefit.''

She recommends that elderly patients who have frequent falls should be referred to a specialist in cardiovascular assessment.

''Falls among people over 50 are the most common single reason for visits to physicians and hospital emergency departments in the UK and are a major healthcare and cost priority. It is estimated that 30 per cent of those over 65 will experience falls or fainting, with 15 per cent of the falls being unexplained.

''This figure rises to 60 per cent in nursing homes. Falls are the sixth leading cause of death in older adults and in 40 to 60 per cent of the cases, fainting episodes are unwitnessed, making a diagnosis much more challenging for physicians,'' said Professor Kenny.

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