Abstract
Objectives
Falls are associated with several negative outcomes. Early identification of those
who are at risk of falling is of importance in geriatrics, and comprehensive geriatric
assessment (CGA) seems to be promising in this regard. Therefore, the present study
investigated whether the multidimensional prognostic index (MPI), based on a standard
CGA, is associated with falls in the Osteoarthritis Initiative (OAI).
Design
Longitudinal, 8 years of follow-up.
Setting and participants
Community-dwelling older people (≥65 years of age) with knee osteoarthritis or at
high risk for this condition.
Methods
A standardized CGA including information on functional, nutritional, mood, comorbidities,
medications, quality of life, and cohabitation status was used to calculate a modified
version of the MPI, categorized as MPI-1 (low), MPI-2 (moderate), and MPI-3 (high
risk). Falls were self-reported and recurrent fallers were defined as ≥2 in the previous
year. Logistic regression was carried out and results are reported as odds ratio (ORs)
with their 95% confidence intervals (CIs).
Results
The final sample consisted of 885 older adults (mean age 71.3 years, female = 54.6%).
Recurrent fallers showed a significant higher MPI than their counterparts (0.46 ± 0.17
vs 0.38 ± 0.16; P < .001). Compared with those in MPI-1 category, participants in MPI-2 (OR 2.13; 95%
CI 1.53‒2.94; P < .001) and in MPI-3 (OR 5.98; 95% CI 3.29-10.86; P < .001) reported a significant higher risk of recurrent falls over the 8-years of
follow-up. Similar results were evident when using an increase in 0.1 points in the
MPI or risk of falls after 1 year.
Conclusions and implications
Higher MPI values at baseline were associated with an increased risk of recurrent
falls, suggesting the importance of CGA in predicting falls in older people.
Keywords
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Article info
Publication history
Published online: November 25, 2019
Footnotes
The Osteoarthritis Initiative (OAI) is a public-private partnership comprised of 5 contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer,Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use data set and does not necessarily reflect the opinions or views of the OAI investigators, the National Institutes of Health, or the private funding partners.
The authors declare no conflicts of interest.
Identification
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© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
