Does carotid stenosis contribute to falls?

From the Research

Carotid Stenosis and Falls

• Carotid stenosis has been associated with an increased risk of falls in older adults 1, 2.
• Studies have shown that asymptomatic carotid stenosis can lead to impaired mobility and cognition, which can increase the risk of falls 1, 3.
• The presence of carotid plaque and increased common carotid intima-media thickness (CCA-IMT) have been linked to a higher risk of fall-related hospitalizations 2.
• Carotid revascularization has been shown to improve balance and mobility in patients with high-grade asymptomatic carotid stenosis, suggesting that carotid stenosis is a modifiable risk factor for falls 3.
• The presence of a carotid bruit, which is a sign of carotid stenosis, has been found in a significant proportion of adults with unexplained or recurrent falls, highlighting the importance of considering carotid stenosis in the evaluation of falls 4.

Mechanisms and Pathogenesis

• Carotid atherosclerosis is a chronic, complex, inflammatory process that can lead to the formation of atherosclerotic plaques and subsequent carotid stenosis 5.
• Endothelial dysfunction, decreased nitric oxide bioavailability, and increased superoxide production are key molecular mechanisms involved in the pathogenesis of carotid atherosclerosis 5.
• The degree of stenosis and the presence of symptoms are important factors in determining the management of carotid stenosis, with carotid intervention being recommended for symptomatic high-grade carotid stenosis 5.

Clinical Implications

• The association between carotid stenosis and falls highlights the importance of considering vascular health in the evaluation and management of falls in older adults 1, 2.
• Carotid revascularization may be a useful intervention for improving balance and mobility in patients with high-grade asymptomatic carotid stenosis 3.
• Further research is needed to fully understand the relationship between carotid stenosis and falls, and to determine the optimal management strategies for preventing falls in patients with carotid stenosis 1, 2, 3, 4, 5.