Abstract
Objective
To examine the association between the baseline number of chronic diseases and multimorbidity
with regard to the incidence of all and injurious falls over 3 years among European
community-dwelling older adults.
Design
Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial.
Setting and participants
Multicenter trial with 7 European centers: Zurich, Basel, Geneva (Switzerland), Berlin
(Germany), Innsbruck (Austria), Toulouse (France), and Coimbra (Portugal), including
2157 community-dwelling adults aged 70 years and older without any major health events
in the 5 years prior to enrollment, sufficient mobility, and good cognitive status.
Methods
The main outcomes were the number of all falls and injurious falls experienced over
3 years. The number of chronic diseases and multimorbidity, defined as the presence
of 3 or more chronic diseases at baseline, were assessed with the Self-Administered
Comorbidity Questionnaire by Sangha et al.
Results
Among the 2155 participants included in the analyses (mean age: 74.9 years, 62% were
women, 52% were physically active more than 3 times a week), 569 (26.4%) had multimorbidity
at baseline. Overall, each 1-unit increase in the baseline number of chronic diseases
was linearly associated with a 7% increased incidence rate of all falls [adjusted
incidence rate ratio (aIRR) 1.07, 95% CI 1.03-1.12, P < .001] and a 6% increased incidence rate of injurious falls (aIRR 1.06, 95% CI 1.02-1.11,
P = .003). Baseline multimorbidity was associated with a 21% increased incidence rate
of all falls (aIRR 1.21, 95% CI 1.07-1.37, P = .002) and a 17% increased incidence rate of injurious falls (aIRR 1.17, 95% CI
1.03-1.32, P = .02).
Conclusions and Implications
Baseline number of prevalent chronic diseases and multimorbidity in generally healthy
and active community-dwelling older adults were associated with increased incidence
rates of all and injurious falls over 3 years. These findings support that multimorbidity
may need consideration as a risk factor for falls, even in generally healthy and active
older adults.
Keywords
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Article info
Publication history
Published online: January 16, 2023
Accepted:
December 6,
2022
Received in revised form:
October 25,
2022
Received:
August 7,
2022
Publication stage
In Press Corrected ProofFootnotes
The DO-HEALTH Research members are listed in the Supplementary Material.
Funding sources: The DO-HEALTH study was funded by the Seventh Research Framework Program of the European Commission (grant agreement no. 278588), and within this framework, also by the University of Zurich (Chair for Geriatric Medicine and Aging Research), DNP, Roche, NESTEC, Pfizer, and Streuli. The funding/supporting organizations had no role in the design and conduct of DO-HEALTH, including collection, management, analysis, and interpretation of the data, as well as preparation, review, or approval of the manuscript, or decision to submit the manuscript for publication.
Sarah Huberty and Gregor Freystätter contributed equally to this work.
Identification
Copyright
© 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
