Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions

BMC Geriatrics

Research Article

Sarah E Munce¹  Sharon E Straus²  Kathryn M Sibley³  Susan B Jaglal⁴  Jennifer Voth⁵ 

[1] Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada;Li-Ka-Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada;Department of Medicine, University of Toronto, Toronto, Canada;Toronto Rehabilitation Institute, University Health Network, Toronto, Canada;Department of Physical Therapy, University of Toronto, Toronto, Canada;Toronto Rehabilitation Institute, University Health Network, Toronto, Canada;Department of Physical Therapy, University of Toronto, Toronto, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada;Toronto Rehabilitation Institute, University Health Network, Toronto, Canada;Department of Psychology, University of Windsor, Windsor, Canada;

关键词: Chronic Obstructive Pulmonary Disease;    Chronic Condition;    Fall Risk;    Fall Rate;    Canadian Community Health Survey;   

DOI  :  10.1186/1471-2318-14-22

 received in 2013-09-13, accepted in 2014-02-11,  发布年份 2014

来源: Springer

【 摘 要 】

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.

【 授权许可】

Unknown   
© Sibley et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.