Category: Geriatric Rehabilitation; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Cross-Cutting
To examine the association of comorbidities and using medications with falls in older adults with osteoarthritis (OA).
Design : Retrospective study.
Setting : Data from a tertiary hospital.
Participants (or Animals, Specimens, Cadavers) :
Data from 760 older adults (≥65 years) who were seen between 2011 and 2017 with at least 2 diagnoses codes using either International Classification of Disease 9threvision (ICD-9) or 10threvision (ICD-10) for OA were included. The first OA diagnosis was set as the index date.
Interventions : Not applicable.
Main Outcome Measure(s) :
Fall history was extracted as self-reported in the last 12 months. Participants were categorized to fallers if they reported at least one fall or non-fallers if they reported no falls. Demographic information (age, sex and race) were included. Comorbidities were obtained with at least 2 ICD-9 or ICD-10 including T2DM, hypertension, dyslipidemia, neuropathy, depression, anxiety, and sleep disorders. Medication list was obtained within 90 days of the index date including pain medications (opioids, non-opioids and benzodiazepine)antidiabetics (insulin or hypoglycemic), antihypertensives, antilipemic and antidepressants. Stepwise logistic regression was used.
The final model shows significant associations between increased risk of falls and age (Odds Ratio (OR) 1.03, 95% Confidence Interval (CI) [1.01-1.05], p=0.03), hypertension (OR 1.83, CI [1.26-2.65], p=0.002), neuropathy (OR 2.58, CI [1.38-4.83], p=0.003), and antidepressant (OR 1.81, CI [1.15-2.86], p=0.011). Using antilipemic was associated with decreased risk of fall (OR .63, CI [.42-.95], p=0.030).
Conclusions : This study identified specific factors that were associated with increased risk of fall in older adults with OA. Comorbidities might influence balance and strength. The side effect of antidepressants including fatigue and dizziness might explain this association. However, there is a need to understand the underlying mechanisms of the negative association between antilipemic and fall.
Aqeel Alenazi– Lecturer, Prince Sattam Bin Abdulaziz University, Kansas City, Missouri
Bader Alqahtani– Assistant Professor, Prince Sattam Bin Abdulaziz University, Pittsburgh, Pennsylvania
Lemuel Waitman– Professor, Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
Patricia Kluding– Professor and Chair, University of Kansas Medical Center, Kansas City, Kansas
Mohammed Alshehri– Research assistance, KUMC, Lenexa, Kansas