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Session: Poster session I
Session starts: Thursday 24 January, 15:00

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Arjen Mol (aDepartment of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit, Van der Boechorstraat 9, 1081 BT, Amsterdam, The Netherlands. )
Phuong Thanh Silvie Bui Hoang (The University of Melbourne, City Campus, Level 6 North, 300 Grattan Street, Parkville, Victoria 3050, Melbourne, Australia)
Sifat Sharmin (Melbourne Academic Centre for Health, Faculty of Medicine, Dentistry and Health Sciences, Building 181, University of Melbourne, Grattan St, Parkville, Victoria 3050, Melbourne, Australia)
Esmee Reijnierse (cDepartment of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, City Campus, Level 6 North, 300 Grattan Street, Parkville, Victoria 3050, Melbourne, Australia)
Richard van Wezel (bDepartment of biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Faculty of Science, Huygensbuilding, Heijendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands)
Carel Meskers (Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands)
Andrea Maier (Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit, Van der Boechorstraat 9, 1081 BT, Amsterdam, The Netherlands)

Abstract:
Background: Orthostatic hypotension is a potential risk factor for falls in older adults, but existing evidence on this relationship is inconclusive. The aim of this study was to perform a systematic review and meta-analysis of the literature assessing the association between orthostatic hypotension and falls. Methods: A literature search was performed on February 20th 2017 in MEDLINE (from 1946), PubMed (from 1966) and EMBASE (from 1947) using the terms “orthostatic hypotension”, “postural hypotension” and “falls”. References of included studies were screened for other eligible studies. Study selection was performed independently by two reviewers using the following inclusion criteria: published in English; mean/median age of the population ≥ 65 years; blood pressure measurement before and after postural change; assessment of the association of orthostatic hypotension with falls. The following studies were excluded: studies provoking orthostatic hypotension by exercise or medication; conference abstracts, case reports, reviews and editorials. Data extraction was performed independently by two reviewers, in accordance with the PRISMA and MOOSE guidelines. Unadjusted odds ratios were used for pooling using a random-effects model. Studies were rated as high, moderate or low quality using the Newcastle Ottawa Scale. Results: Out of 5646 studies, 63 studies (51,800 individuals) were included in the systematic review and 50 studies (49,164 individuals) in the meta-analysis. Out of 63 studies, 39 were cross-sectional and 24 were longitudinal. Orthostatic hypotension was positively associated with falls (odds ratio 1.73, 95% confidence interval 1.50-1.99). The result was independent of study population, study design, study quality, orthostatic hypotension definition and blood pressure measurement method. Conclusions: Orthostatic hypotension is significantly positively associated with falls in older adults, underpinning the clinical relevance to test for an orthostatic blood pressure drop and highlighting the need investigate orthostatic hypotension treatment to potentially reduce falls.