Falls, non-accidental falls and syncope in community-dwelling adults aged 50 years and older: Implications for cardiovascular assessment

OBJECTIVES To calculate the prevalence of all falls, non-accidental falls and syncope in an older population and characterize cardiovascular risk profiles. DESIGN Prospective, longitudinal cohort study. SETTING The first two waves of data from the Irish Longitudinal Study on Ageing (TILDA). PARTICIPANTS 8172 community-dwelling adults aged 50 years and older resident in the Republic of Ireland. MEASUREMENTS Self-reported history of all falls, non-accidental falls and syncope in the year preceding the first two waves of data collection. Demographic factors and self-reported cardiovascular conditions were used to characterize cardiovascular risk profiles. RESULTS The prevalence of all falls in the past year was 19.2% or 192 per thousand persons and increased with age (50-64 years 17.5%; 65-74 years 19.4%; 75+ years 24.4%). Non-accidental falls had an estimated prevalence of 5.1% or 51 falls per thousand persons and accounted for 26.5% of all falls reported and also increased with age (50-64 years 4.0%; 65-74 years 5.5%; 75+ years 8.0%). The prevalence for syncope was estimated to be 4.4% or 44per thousand persons but did not show a similar age gradient. Participants with at least 5 cardiovascular conditions were more likely to report all falls (OR = 2.07, 95% CI 1.18-3.64, p<0.05) and NAF (OR = 2.89, 95%CI 1.28-6.52, p<0.05). CONCLUSIONS The prevalence of all falls and non-accidental falls increases with age but the same pattern was not consistently observed for syncope. There is an increased odds of reporting all three outcomes with increasing number of self-reported cardiovascular conditions. Further work is needed to uncover the interplay between cardiovascular disease and subsequent falls.