Falls and fractures in subjects over 65 years old and their associations with geriatric syndromes: Russian epidemiological study EVKALIPT

Abstract

Background. In the Russian Federation, the prevalence of falls and fractures in older people in the general population is unknown. Single studies have been carried out on small samples (hospitalized patients, patients with diabetes mellitus etc.). Objective. To investigate history of low-energy fractures, frequency of falls in the past year and their associations with other geriatric syndromes (GS) in subjects aged ≥65 years.Materials and methods. We examined 4308 subjects (30% of men) aged 65 to 107 years (mean age 78 ± 8 years) in 11 regions of the Russian Federation, who were divided into 3 age groups (65-74, 75-84 and ≥85 years old). All participants underwent comprehensive geriatric assessment, which consisted of two stages: 1) survey on a specially designed questionnaire; 2) physical examination.Results. The frequency of falls over the past year was 30%, including 25,7% — in subjects aged 65-74 yrs, 29,8% — 75-84 yrs, 37,3% — ≥85 yrs (p for trend <0,001). Of these, 62% of participants fell 1 time, 38% — 2 times or more. With the same frequency, the subjects fell at home (41%) and on the street (42%), 17% of subjects fell both at home and on the street. A history of low-energy fractures was found in 17% of the participants, among which the most frequent (63%) were fractures of the radius. Univariate regression analysis with sex and age (as a discret variable) adjustment, where the falls in the past year were considered as the dependent variable, and GS as independent one, demonstrated that all GS were associated with falls in the past year with odds ratios (ORs) ranging from 1,25 to 3,13. Multivariate regression analysis with age and sex adjustment showed that independent predictors of falls were female gender (ORs 1,51; 95% confidence interval 1,26-1,82; р<0,001) and 6 GS (malnutrition, depression, urinary and fecal incontinence, chronic pain and dependence in instrumental activities in daily life) with a 1,3-2,4 times increase of falls risk.Conclusion. In EVKALIPT study we firstly obtained the domestic data on the prevalence of falls and low-energy fractures history in subjects aged >65 years in the general population and studied associations between falls in the past year and other geriatric syndromes.