Medications Polypharmacy is common in older people Sedatives significantly increase the risk of falling Cardiovascular medications can contribute towards falls Visual impairment Glaucoma, macular degeneration and retinopathy increase the risk of falling[citation needed] Bifocals and trifocals can increase the risk of falling as the lower portion of corrective lenses are optimized for distances approximately 18inches, thus precluding clear vision of one's feet/floor, approximately 4.5 to 5.5 feet below one's eyes. Cognitive problems Dementia increases the likelihood of falls Cardiovascular causes Orthostatic hypotension Postprandial hypotension Carotid sinus syndrome Neurocardiogenic syncope– the commonest cause of syncope in A&E patients Cardiac arrhythmias Structural heart disease, such as valvular heart disease