Orthostatic hypotension in older nursing home residents who fall: are they dizzy?

Orthostatic hypotension (OH) and dizziness have been linked to older adult falls. As a treatable condition, the detection of OH is of clinical importance to falls prevention. Gaps in the literature about symptoms associated with OH among older adult fallers, such as dizziness led to this secondary analysis of blood pressure data and reported symptoms. Of the 194 Registered Nurse (RN) documented falls, most (n = 91; 46.9%) failed to meet the prevailing diagnostic criteria for OH; 18 (9.2%) met criteria; and 8 (4%) nearly met the OH criteria. OH determinations were incomplete or absent in 41% (n = 77). Of the 18 residents with OH, none reported dizziness, instead half reported loss of balance. We conclude, older residents did not report symptoms of dizziness prior to OH drops in blood pressure and falls. Further study is warranted to identify other predictive symptoms of OH and to evaluate nursing staff's understanding of OH.