{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:12:19Z","timestamp":1782778339489,"version":"3.54.5"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T00:00:00Z","timestamp":1596758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["RGPIN-6473"],"award-info":[{"award-number":["RGPIN-6473"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Impaired blood pressure (BP) recovery with orthostatic hypotension on standing occurs in 20% of older adults. Low BP is associated with low cerebral blood flow but mechanistic links to postural instability and falls are not established. We investigated whether posture-related reductions in cerebral tissue oxygenation (tSO2) in older adults impaired stability upon standing, if a brief sit before standing improved tSO2 and stability, and if Low-tSO2 predicted future falls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>Seventy-seven older adults (87 \u00b1 7 years) completed (i) supine\u2013stand, (ii) supine\u2013sit\u2013stand, and (iii) sit\u2013stand transitions with continuous measurements of tSO2 (near-infrared spectroscopy). Total path length (TPL) of the center of pressure sway quantified stability. K-cluster analysis grouped participants into High-tSO2 (n = 62) and Low-tSO2 (n = 15). Fall history was followed up for 6 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Change in tSO2 during supine\u2013stand was associated with increased TPL (R = \u2212.356, p = .001). When separated into groups and across all transitions, the Low-tSO2 group had significantly lower tSO2 (all p &amp;lt; .01) and poorer postural stability (p &amp;lt; .04) through 3 minutes of standing compared to the High-tSO2 group. There were no effects of transition type on tSO2 or TPL for the High-tSO2 group, but a 10-second sitting pause improved tSO2 and enhanced postural stability in the Low-tSO2 group (all p &amp;lt; .05). During 6-month follow-up, the Low-tSO2 group had a trend (p &amp;lt; .1) for increased fall risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This is the first study to show an association between posture-related cerebral hypoperfusion and quantitatively assessed instability. Importantly, we found differences among older adults suggesting those with lower tSO2 and greater instability might be at increased risk of a future fall.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gerona\/glaa194","type":"journal-article","created":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T14:08:37Z","timestamp":1596809317000},"page":"1124-1133","source":"Crossref","is-referenced-by-count":16,"title":["Older Adults\u2019 Drop in Cerebral Oxygenation on Standing Correlates With Postural Instability and May Improve With Sitting Prior to Standing"],"prefix":"10.1093","volume":"76","author":[{"given":"Laura K","family":"Fitzgibbon-Collins","sequence":"first","affiliation":[{"name":"Schlegel-University of Waterloo Research Institute for Aging, Ontario, Canada"},{"name":"Department of Kinesiology, University of Waterloo, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A","family":"Heckman","sequence":"additional","affiliation":[{"name":"Schlegel-University of Waterloo Research Institute for Aging, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikdip","family":"Bains","sequence":"additional","affiliation":[{"name":"Schlegel-University of Waterloo Research Institute for Aging, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamiko","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, University of Waterloo, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E","family":"McIlroy","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, University of Waterloo, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6915-2959","authenticated-orcid":false,"given":"Richard L","family":"Hughson","sequence":"additional","affiliation":[{"name":"Schlegel-University of Waterloo Research Institute for Aging, Ontario, Canada"},{"name":"Department of Kinesiology, University of Waterloo, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,7]]},"reference":[{"key":"2021052203191840400_CIT0001","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/MEJ.0000000000000548","article-title":"The prevalence of unexplained falls and syncope in older adults presenting to an Irish urban emergency department","volume":"26","author":"Bhangu","year":"2019","journal-title":"Eur J Emerg Med."},{"key":"2021052203191840400_CIT0002","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/S0895-4356(01)00349-3","article-title":"Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly","volume":"54","author":"Tromp","year":"2001","journal-title":"J Clin Epidemiol."},{"key":"2021052203191840400_CIT0003","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1111\/jgs.15304","article-title":"Medical costs of fatal and nonfatal falls in older adults","volume":"66","author":"Florence","year":"2018","journal-title":"J Am Geriatr Soc."},{"key":"2021052203191840400_CIT0004","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/ajh\/hpw108","article-title":"Orthostatic hypotension in middle-age and risk of falls","volume":"30","author":"Juraschek","year":"2017","journal-title":"Am J Hypertens"},{"key":"2021052203191840400_CIT0005","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1001\/jamainternmed.2017.2937","article-title":"Association of history of dizziness and long-term adverse outcomes with early vs later orthostatic hypotension assessment times in middle-aged adults","volume":"177","author":"Juraschek","year":"2017","journal-title":"JAMA Intern Med."},{"key":"2021052203191840400_CIT0006","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1111\/jgs.14563","article-title":"Impaired orthostatic blood pressure recovery is associated with unexplained and injurious falls","volume":"65","author":"Finucane","year":"2017","journal-title":"J Am Geriatr Soc."},{"key":"2021052203191840400_CIT0007","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jamda.2015.08.022","article-title":"The association of cardiovascular disorders and falls: a systematic review","volume":"17","author":"Jansen","year":"2016","journal-title":"J Am Med Dir Assoc."},{"key":"2021052203191840400_CIT0008","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/ageing\/afx024","article-title":"Is orthostatic hypotension related to falling? 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