Abstract
PurposeThe aim of the current study was to evaluate the association between a decreased estimated glomerular filtration rate (eGFR) and accidental falling in elderly patients who visited the day clinic of the department of geriatric medicine of the University of Medical Center Utrecht (UMCU).Study designA cross-sectional analysis with people aged ≥ 65 years of the Utrecht Cardiovascular Cohort was performed. Patients were stratified into different stages of kidney disease (< 45, 45–59, and ≥ 60 ml/min per 1.73 m2). Logistic regression models were used to evaluate the association between chronic kidney disease and falling.ResultsOur analysis included 1000 participants with a mean age 79.4 (± 6.6) years, of whom 38% had an eGFR of < 60 ml/min per 1.73 m2 and 17% < 45 ml/min per 1.73 m2. Univariate analysis showed a significant higher prevalence [odds ratio 1.75 (95% confidence interval 1.21–2.53; p ≤ 0.01)] of falling in the population with an eGFR < 45 ml/min per 1.73 m2 compared to patients with an eGFR ≥ 60 ml/min per 1.73 m2. After correcting for multiple potential confounders in the multivariate analysis, this association was no longer present.ConclusionsIn geriatric patients ≥ 65 years, patients with a decreased eGFR fall more often than patients with a preserved kidney function. This seems to be related with the risk profile of patients with CKD and not with a decreased eGFR itself, as after correcting for potential confounders no association remained. Nevertheless, accidental falling is a highly prevalent problem in the elderly CKD population. Therefore, nephrologists should actively ask about accidental falling, and thereby screen for high-risk patients.
Highlights
Accidental falling is a common problem in the elderly population
SD standard deviation, IQR interquartile range, CCI Charlson comorbidity index, Accidental fall fall in the previous year, Frequent falls ≥ 2 falls in the previous year
Patients with an estimated glomerular filtration rate (eGFR) < 45 ml/min per 1.73 m2 had significantly higher rates of accidental falling compared to patients with a preserved kidney function
Summary
Accidental falling is a common problem in the elderly population. Approximately one-third of people aged ≥ 65 years fall each year, increasing to around 40% for those ≥ 70 years of age Heidelberglaan 100, 3584 CX Utrecht, The Netherlands 3 Department of Geriatrics, Diakonessenhuis Utrecht, Utrecht, The Netherlands 4 Department of Geriatrics, Academic Medical CenterAmsterdam, Amsterdam, The Netherlands 5 Department of Nephrology and Hypertension, UtrechtUniversity, Utrecht, The Netherlands [1]. Accidental falling is a common problem in the elderly population. One-third of people aged ≥ 65 years fall each year, increasing to around 40% for those ≥ 70 years of age Heidelberglaan 100, 3584 CX Utrecht, The Netherlands 3 Department of Geriatrics, Diakonessenhuis Utrecht, Utrecht, The Netherlands 4 Department of Geriatrics, Academic Medical Center. University, Utrecht, The Netherlands [1]. These rates are even higher in institutionalized elderly [2]. Falls can result in serious injury, loss of independence, functional decline, and death. Unintentional injuries are the fifth leading cause of death in older adults, and falls are responsible for two-thirds of these deaths [3]. Important biological risk factors are age, gender, physical decline, cognitive impairment, depression, and comorbidity. Important behavioral risk factors are the use of multiple medications, malnutrition, and excess alcohol use [1]
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