Falling: is the heart to blame?

heartSofie Jansen is a research fellow at the department of Geriatric Medicine in the Academic Medical Center in Amsterdam, the Netherlands. Her PhD focusses on the contribution of cardiovascular diseases to falls in older adults. Last year she spent six months as a visiting researcher in Trinity College, Dublin. In 2015 she will start her training as a Medical & Geriatrics Registrar. In this blog she comments on her recent publication in Age and Ageing journal. 

People often consider falling to be an unavoidable consequence of old age – we’ve all heard stories of a grandmother or elderly aunt who has taken a tumble. As such, falls are often accepted as a fact of life by older persons and those who care for them. But is this really the case? There are a number of factors that individually, or in combination, can contribute to people falling: balance problems, poor vision, the side-effects of medication. Most of these factors can be treated or targeted, leading to a reduction in falls. Recognition of these treatable risk factors is therefore important.

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Atrial Fibrillation: The real story behind the new NICE guidelines

Richard Bogle is a Consultant Cardiologist based in London and Surrey. He specialises in the assessment and treatment of patients with all types of heart and vascular disease. He tweets at @richardbogleshutterstock_180215222

If you watched the news this week you might have thought that the only recommendation in the NICE Atrial Fibrillation Guideline was that doctors should not prescribe aspirin to prevent strokes. In fact most cardiologists and geriatricians stopped using aspirin for this condition several years ago and the NICE recommendation simply reaffirms those issued previously by other professional societies such as the European Society of Cardiology.

The real story behind the guidelines was, in my opinion, nothing to do with medication or rate versus rhythm but rather the importance of delivering a personalised package of care for patients with atrial fibrillation (AF). Recognising that AF is a long term health condition there is emphasis on the importance of shared decision making processes particularly around anticoagulation. Alongside the guideline NICE published a Patient Decision Aid to assist with this process.  Continue reading