Abstract

BackgroundFalls are a major problem for older people and recurrent fallers are especially prone to severe consequences due to falls. This study investigated the association between chronic conditions and falls.MethodsResponses from 872 older persons (age 65–98) to a health questionnaire were used in the analyses. Characteristics and disease prevalence between recurrent fallers, one-time fallers and non-fallers were compared. A hierarchical clustering method was applied to find combinations of chronic conditions that were associated with recent recurrent falling.ResultsThe results showed that recurrent fallers had a higher number of diseases (median 4, interquartile range, IQR = 2.0–5.0) compared to non-fallers (median 2, IQR = 1.0–3.0). Eight clusters were formed based on the data. The participants in the low chronic disease cluster were younger, more physically active, not frail, and had fewer geriatric conditions. Multiple chronic disease cluster participants were older, less physically active, overweight (body mass index, BMI > 30), at risk of malnutrition, and had more geriatric conditions. Significantly increased risk of recurrent falls relative to the low chronic cluster was found for respondents in the osteoporosis cluster and multiple chronic disease cluster (OR = 5.65, 95% confidence interval CI: 1.23–25.85, p = 0.026, and OR = 13.42, 95% CI: 2.47–72.96, p = 0.002, respectively). None of the clusters were associated with increased risk of one-time falling.ConclusionsThe results implicate that the number of chronic diseases is related with risk of recurrent falling. Furthermore, the results implicate the potential of identifying certain combinations of chronic diseases that increase fall risk by analyzing health record data, although further studies are needed with a larger population sample.

Highlights

  • Falls are a major problem for older people and recurrent fallers are especially prone to severe consequences due to falls

  • This study examined the association between chronic diseases and falls in a sample of older people and demonstrated that fall incidence among community-dwelling older people is highly linked to presence of chronic disease

  • We found that the percentage of subjects who reported poor sleep quality is higher in the recurrent fallers group and one-time fallers group compared to non-fallers (19.5, 12.5, 7.1%, respectively), and similar findings were made regarding frailty according to the modified Study of Osteoporotic Fractures (SOF)-index (40, 7.6 and 5.7%), and malnutrition according to Mini Nutritional Assessment (MNA) (37.5, 22.5 and 12.3%)

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Summary

Introduction

Falls are a major problem for older people and recurrent fallers are especially prone to severe consequences due to falls. Falls of older adults are globally a major health, economic and societal problem. The costs resulting from falls and their consequences are increasing rapidly, and the importance of fall prevention grows. Identifying recurrent fallers is especially important as they are more prone to severe consequences compared to non-recurrent fallers. In a prospective study by Pluijm et al 11.9% of recurrent fallers (at least two falls within 6 months) had a fall-related fracture compared to 3.4% of non-recurrent fallers [13]. One-time fallers (1 fall within 1 year) and recurrent fallers are reported to have distinct characteristics with respect to age, physiology, cognition, fear of falling and ability to perform daily activities [14,15,16]

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