Abstract
There is an increasing prevalence of diabetes mellitus (DM) and diabetic peripheral neuropathy (DPN) in older people in many countries across the world. Older adults with type 2 DM have a significantly higher incidence of falls compared with their counterparts without DM. This review synthesize published findings on sensorimotor, cognitive, balance and mobility impairments, and their associations with falls in people with DM and DPN. Given the high incidence of falls and resulting serious consequences, systematically assessing fall risk in people with DM may optimize fall prevention strategies and reduce the associated morbidity, mortality and the rehabilitation costs for people with these conditions. These findings indicate balance, gait, sensorimotor and cognitive assessments should be administered to DM patients, especially in those with DPN, to document impairment levels and target interventions to reduce falls and associated morbidity, mortality and rehabilitation costs.
Highlights
Falls are a serious public health issue that contributes to substantial morbidity and mortality in older people
People with diabetic peripheral neuropathy (DPN) have impaired dynamic and functional balance with increased mediolateral sway in this group identified as a risk factor for sideway falls
Gait changes of people with diabetes mellitus (DM) are associated with physical, cognitive–behavioral factors and DPN severity
Summary
Falls are a serious public health issue that contributes to substantial morbidity and mortality in older people. A fall for many people has adverse consequences, including loss of independent living and decreased functioning in daily life. WHO data indicate 37.3 million falls occur each year that are severe enough to require medical attention [1], resulting in an enormous economic burden. WHO data indicate the average cost per fall injury is US$3611 in the Republic of Finland and US$1049 in Australia, for people aged 65 years or older [1]. Falls are the second leading cause of accidental or unintentional injury deaths worldwide [1]. The WHO estimated that 646,000 individuals die from falls each year, and of these more than 80% occur in low and middle income countries [1]
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