Abstract
BackgroundFalls and chronic disease are both important health issues in older adults. The objectives of this study were to quantify the prevalence of falls and multi-morbidity (≥2 chronic conditions) in Canadian older adults; examine associations between falls and number of chronic conditions; and explore whether certain patterns of chronic disease were associated with a greater risk of falling.MethodsData were derived from the Canadian Community Health Survey- Healthy Aging. Primary outcomes from 16,357 community-dwelling adults aged 65 years and over were self-reported falls in the previous 12 months and presence of 13 chronic conditions. Prevalence estimates were calculated with normalized sampling weights, and hierarchical cluster analysis was used to identify clusters based on chronic condition patterns, and tested for association to falls with logistic regression.ResultsOverall prevalence of falling and multi-morbidity were 19.8% and 62.0% respectively. Fall risk was significantly greater in individuals with one, two, four, five and six or more chronic conditions relative to those with none (all p < 0.05). A seven-cluster model was selected, including groups with low prevalence of chronic disease, or high prevalence of hypertension and arthritis, visual impairment, hypertension, chronic obstructive pulmonary disease (COPD), diabetes, or heart disease and hypertension. Only the hypertension cluster (Odds Ratio [OR] = 1.2) and COPD cluster (OR = 1.6) were significantly associated with increased falls relative to the low prevalence group.ConclusionsBoth the number and pattern of chronic conditions were related to falls. COPD emerged as a significant predictor of falls despite affecting a smaller proportion of respondents. Continued study is warranted to verify this association and determine how to incorporate consideration of chronic disease and multi-morbidity into fall risk assessments.
Highlights
Falls and chronic disease are both important health issues in older adults
The overall proportion of individuals who reported falling in the previous year was 19.8%
With respect to type, when considering combinations of chronic disease identified by cluster analysis, though some conditions were relatively evenly distributed across all clusters and others were concentrated primarily in one cluster, two groups of individuals were associated with increased risk of falls relative to the group with low prevalence of chronic disease: “hypertension” and “chronic obstructive pulmonary disease (COPD)”
Summary
Falls and chronic disease are both important health issues in older adults. The objectives of this study were to quantify the prevalence of falls and multi-morbidity (≥2 chronic conditions) in Canadian older adults; examine associations between falls and number of chronic conditions; and explore whether certain patterns of chronic disease were associated with a greater risk of falling. Many factors contribute to falls, and among these, a number of chronic conditions, including arthritis, diabetes and visual impairment, are associated with increased fall risk [4]. Current fall prevention guidelines [9] do not explicitly account for the role of chronic disease (either in single or multiple), and many of the practice guidelines for individual chronic diseases do not consider multi-morbidity or falls [10,11]. This may be due to the limited information on the association between total disease burden and falls from which to inform guidelines. Given the varied nature of aging and range of conditions associated with increased fall risk, a comprehensive approach to considering multi-morbidity in relation to falls is warranted
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