Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives

Nandu Goswami,1 Carolina Abulafia,2 Daniel Vigo,2 Maximilian Moser,1 Germaine Cornelissen,3 Daniel Cardinali2 1Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria; 2Institute for Biomedical Research (BIOMED), Ca...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Goswami N, Abulafia C, Vigo D, Moser M, Cornelissen G, Cardinali D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	falls aging orthostatic intolerance autonomic vagus Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/242b2d8e9c754e5d84f557438ad913d4
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:242b2d8e9c754e5d84f557438ad913d4
record_format	dspace
spelling	oai:doaj.org-article:242b2d8e9c754e5d84f557438ad913d42021-12-02T12:43:52ZFalls Risk, Circadian Rhythms and Melatonin: Current Perspectives1178-1998https://doaj.org/article/242b2d8e9c754e5d84f557438ad913d42020-11-01T00:00:00Zhttps://www.dovepress.com/falls-risk-circadian-rhythms-and-melatonin-current-perspectives-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Nandu Goswami,1 Carolina Abulafia,2 Daniel Vigo,2 Maximilian Moser,1 Germaine Cornelissen,3 Daniel Cardinali2 1Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria; 2Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina; 3Halberg Chronobiology Center, University of Minnesota, Minneapolis, MN, USACorrespondence: Nandu GoswamiPhysiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstrasse 6, D-5, Graz A 8036, AustriaTel + 43 316 38573852Fax + 43 316 385 79005Email nandu.goswami@medunigraz.atAbstract: Aging is associated with weakening of the circadian system. The circadian amplitude of most physiological variables is reduced, while the circadian phase becomes more labile and tends to occur earlier with advancing age. As the incidence of falls in older persons could follow circadian variations, a better understanding of conditions in which falls occur can lead to the implementation of countermeasures (such as adjusting the scheduling of hospital staff, or changing the timing of anti-hypertensive medication if falls are related to undesirable circadian patterns of blood pressure and/or heart rate). This includes knowing the times of the day, days of the week, and times of the year when falls are more likely to occur at home or in the hospital. Additionally, the links between aging processes and factors associated with an increased risk of developing autonomic dysfunction are well established. A strong association between heart rate variability indexes and aging has been shown. Circadian rhythms of autonomous nervous system activity may play important role for maintenance of orthostatic tolerance. Whether one is concerned with disease prediction and prevention or maintenance of healthy aging, the study of circadian rhythms and the broader time structure underlying physiopathology is helpful in terms of screening, early diagnosis and prognosis, as well as the timely institution of prophylactic and/or palliative/curative treatment. Timing the administration of such treatment as a function of circadian (and other) rhythms also could lead to reduction of falls in older persons. Finally, a prominent circadian rhythm characterizes melatonin, which peaks during the night. The circadian amplitude of melatonin decreases as a function of age, raising the questions whether such a decrease in the circadian amplitude of melatonin relates to a higher risk of falls and, if so, whether melatonin supplementation may be an effective countermeasure. This narrative review assesses the relationships between fall risk and the potential role circadian rhythms and melatonin play in mitigating this risk. We aim to provide healthcare workers adequate information about fall risk in older persons, including the potential role of the circadian rhythms and/or melatonin, as well as to lay foundations for future fall prevention interventional studies.Keywords: falls, aging, orthostatic intolerance, autonomic, vagusGoswami NAbulafia CVigo DMoser MCornelissen GCardinali DDove Medical Pressarticlefallsagingorthostatic intoleranceautonomicvagusGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 2165-2174 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	falls aging orthostatic intolerance autonomic vagus Geriatrics RC952-954.6
spellingShingle	falls aging orthostatic intolerance autonomic vagus Geriatrics RC952-954.6 Goswami N Abulafia C Vigo D Moser M Cornelissen G Cardinali D Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives
description	Nandu Goswami,1 Carolina Abulafia,2 Daniel Vigo,2 Maximilian Moser,1 Germaine Cornelissen,3 Daniel Cardinali2 1Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria; 2Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina; 3Halberg Chronobiology Center, University of Minnesota, Minneapolis, MN, USACorrespondence: Nandu GoswamiPhysiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstrasse 6, D-5, Graz A 8036, AustriaTel + 43 316 38573852Fax + 43 316 385 79005Email nandu.goswami@medunigraz.atAbstract: Aging is associated with weakening of the circadian system. The circadian amplitude of most physiological variables is reduced, while the circadian phase becomes more labile and tends to occur earlier with advancing age. As the incidence of falls in older persons could follow circadian variations, a better understanding of conditions in which falls occur can lead to the implementation of countermeasures (such as adjusting the scheduling of hospital staff, or changing the timing of anti-hypertensive medication if falls are related to undesirable circadian patterns of blood pressure and/or heart rate). This includes knowing the times of the day, days of the week, and times of the year when falls are more likely to occur at home or in the hospital. Additionally, the links between aging processes and factors associated with an increased risk of developing autonomic dysfunction are well established. A strong association between heart rate variability indexes and aging has been shown. Circadian rhythms of autonomous nervous system activity may play important role for maintenance of orthostatic tolerance. Whether one is concerned with disease prediction and prevention or maintenance of healthy aging, the study of circadian rhythms and the broader time structure underlying physiopathology is helpful in terms of screening, early diagnosis and prognosis, as well as the timely institution of prophylactic and/or palliative/curative treatment. Timing the administration of such treatment as a function of circadian (and other) rhythms also could lead to reduction of falls in older persons. Finally, a prominent circadian rhythm characterizes melatonin, which peaks during the night. The circadian amplitude of melatonin decreases as a function of age, raising the questions whether such a decrease in the circadian amplitude of melatonin relates to a higher risk of falls and, if so, whether melatonin supplementation may be an effective countermeasure. This narrative review assesses the relationships between fall risk and the potential role circadian rhythms and melatonin play in mitigating this risk. We aim to provide healthcare workers adequate information about fall risk in older persons, including the potential role of the circadian rhythms and/or melatonin, as well as to lay foundations for future fall prevention interventional studies.Keywords: falls, aging, orthostatic intolerance, autonomic, vagus
format	article
author	Goswami N Abulafia C Vigo D Moser M Cornelissen G Cardinali D
author_facet	Goswami N Abulafia C Vigo D Moser M Cornelissen G Cardinali D
author_sort	Goswami N
title	Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives
title_short	Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives
title_full	Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives
title_fullStr	Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives
title_full_unstemmed	Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives
title_sort	falls risk, circadian rhythms and melatonin: current perspectives
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/242b2d8e9c754e5d84f557438ad913d4
work_keys_str_mv	AT goswamin fallsriskcircadianrhythmsandmelatonincurrentperspectives AT abulafiac fallsriskcircadianrhythmsandmelatonincurrentperspectives AT vigod fallsriskcircadianrhythmsandmelatonincurrentperspectives AT moserm fallsriskcircadianrhythmsandmelatonincurrentperspectives AT cornelisseng fallsriskcircadianrhythmsandmelatonincurrentperspectives AT cardinalid fallsriskcircadianrhythmsandmelatonincurrentperspectives
_version_	1718393672210317312

Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives

Ejemplares similares