Skip to main content
Top
Published in: Osteoporosis International 11/2018

01-11-2018 | Original Article

Role of musculoskeletal disorders in falls of postmenopausal women

Authors: N. Afrin, R. Honkanen, H. Koivumaa-Honkanen, R. Sund, T. Rikkonen, L. Williams, H. Kröger

Published in: Osteoporosis International | Issue 11/2018

Login to get access

Abstract

Summary

We aimed to investigate the role of musculoskeletal disorders (MSDs) as risk factors for falls among postmenopausal women. Our results indicate that MSDs are common and are associated with increased falling risk, especially nonslip falls. Excess number of falls due to MSDs is greater than that due to any other disease class.

Purpose

Falls are a major public health problem worldwide. The aim of the study was to investigate the role of MSDs as risk factors for falls among postmenopausal women.

Methods

This cohort study utilized data from a population-based, prospective cohort study (OSTPRE). The study population consisted of 8656 women aged 57–66 years (in 1999) living in Kuopio Province, Eastern Finland, who responded to postal enquiries in 1999 and 2004. Information on MSDs and other morbidities was obtained from the 1999 enquiry and information on falls from the 2004 enquiry. Women were classified as fallers or non-fallers according to their falling events in the preceding 12 months. The fallers were further divided into women with slip and nonslip falls.

Results

Of the study sample, 53.3% reported a MSD and 39.2% reported a fall during the preceding 12 months. MSDs predicted falls (OR = 1.38; 95% CI 1.26–1.50) and the association was stronger for nonslip (OR = 1.56; 95% CI 1.39–1.75) than slip falls (OR 1.22; 95% CI 1.08–1.38) compared to the women without MSDs. The risk of falls increased with increasing number (1, 2, ≥ 3) of MSDs: 1.25 (95%CI 1.13–1.38), 1.48 (95%CI 1.30–1.68), and 1.92 (95%CI 1.60–2.31), respectively. After adjustments, the risk of falling related to MSDs reduced by about 5% (adjusted p < 0.001). The population attributable fraction of falls due to MSDs was 10.3% of all falls, greater than that due to any other disease class.

Conclusion

MSDs are common and an important risk factor for falls and especially nonslip falls among postmenopausal women. The number of excess falls due to MSDs in this population group is greater than that due to any other disease class.
Appendix
Available only for authorised users
Literature
1.
go back to reference Woolf AD, Akesson K (2001) Understanding the burden of musculoskeletal conditions. The burden is huge and not reflected in national health priorities. BMJ 322(7294):1079–1080CrossRef Woolf AD, Akesson K (2001) Understanding the burden of musculoskeletal conditions. The burden is huge and not reflected in national health priorities. BMJ 322(7294):1079–1080CrossRef
2.
go back to reference Global Burden of Disease Study 2013 Collaborators (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the global burden of disease study 2013. Lancet 386(9995):743–800CrossRef Global Burden of Disease Study 2013 Collaborators (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the global burden of disease study 2013. Lancet 386(9995):743–800CrossRef
3.
go back to reference Kaila-Kangas L (2007) Musculoskeletal disorders and diseases in Finland: results of the health 2000 survey. National Institute for Health and Welfare, Finland, pp 82 Kaila-Kangas L (2007) Musculoskeletal disorders and diseases in Finland: results of the health 2000 survey. National Institute for Health and Welfare, Finland, pp 82
5.
go back to reference Davis J, Robertson M, Ashe M, Liu-Ambrose T, Khan K, Marra C (2010) International comparison of cost of falls in older adults living in the community: a systematic review. Osteoporosis Int 21(8):1295–1306CrossRef Davis J, Robertson M, Ashe M, Liu-Ambrose T, Khan K, Marra C (2010) International comparison of cost of falls in older adults living in the community: a systematic review. Osteoporosis Int 21(8):1295–1306CrossRef
6.
go back to reference Moreland J, Richardson J, Chan D et al (2003) Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology 49(2):93–116CrossRef Moreland J, Richardson J, Chan D et al (2003) Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology 49(2):93–116CrossRef
7.
go back to reference Talbot LA, Musiol RJ, Witham EK, Metter EJ (2005) Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health 5(1):1CrossRef Talbot LA, Musiol RJ, Witham EK, Metter EJ (2005) Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health 5(1):1CrossRef
8.
go back to reference Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 21(5):658–668CrossRef Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 21(5):658–668CrossRef
9.
go back to reference Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent nonsyncopal falls: a prospective study. JAMA 261(18):2663–2668CrossRef Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent nonsyncopal falls: a prospective study. JAMA 261(18):2663–2668CrossRef
10.
go back to reference Armstrong C, Swarbrick CM, Pye SR, O'Neill TW (2005) Occurrence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis 64(11):1602–1604CrossRef Armstrong C, Swarbrick CM, Pye SR, O'Neill TW (2005) Occurrence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis 64(11):1602–1604CrossRef
11.
go back to reference Lord SR, Menz HB (2003) Tiedemann a. A physiological profile approach to falls risk assessment and prevention. Phys Ther 83(3):237–252PubMed Lord SR, Menz HB (2003) Tiedemann a. A physiological profile approach to falls risk assessment and prevention. Phys Ther 83(3):237–252PubMed
12.
go back to reference Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima R (2010) Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study. Osteoporos Int 21(11):1825–1833CrossRef Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima R (2010) Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study. Osteoporos Int 21(11):1825–1833CrossRef
13.
go back to reference Arden NK, Nevitt MC, Lane NE, Gore LR, Hochberg MC, Scott JC, Pressman AR, Cummings SR, for the STUDY OF OSTEOPOROTIC FRACTURES RESEARCH GROUP (1999) Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Arthritis Rheum 42(7):1378–1385CrossRef Arden NK, Nevitt MC, Lane NE, Gore LR, Hochberg MC, Scott JC, Pressman AR, Cummings SR, for the STUDY OF OSTEOPOROTIC FRACTURES RESEARCH GROUP (1999) Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Arthritis Rheum 42(7):1378–1385CrossRef
14.
go back to reference Bhatt T, Wening J, Pai Y (2005) Influence of gait speed on stability: recovery from anterior slips and compensatory stepping. Gait Posture 21(2):146–156CrossRef Bhatt T, Wening J, Pai Y (2005) Influence of gait speed on stability: recovery from anterior slips and compensatory stepping. Gait Posture 21(2):146–156CrossRef
15.
go back to reference Hausdorff JM, Edelberg HK, Mitchell SL, Goldberger AL, Wei JY (1997) Increased gait unsteadiness in community-dwelling elderly fallers. Arch Phys Med Rehabil 78(3):278–283CrossRef Hausdorff JM, Edelberg HK, Mitchell SL, Goldberger AL, Wei JY (1997) Increased gait unsteadiness in community-dwelling elderly fallers. Arch Phys Med Rehabil 78(3):278–283CrossRef
16.
go back to reference Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319(26):1701–1707CrossRef Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319(26):1701–1707CrossRef
17.
go back to reference Afrin N, Honkanen R, Koivumaa-Honkanen H, Lukkala P, Rikkonen T, Sirola J, Williams LJ, Kröger H (2016) Multimorbidity predicts falls differentially according to the type of fall in postmenopausal women. Maturitas 91:19–24CrossRef Afrin N, Honkanen R, Koivumaa-Honkanen H, Lukkala P, Rikkonen T, Sirola J, Williams LJ, Kröger H (2016) Multimorbidity predicts falls differentially according to the type of fall in postmenopausal women. Maturitas 91:19–24CrossRef
18.
go back to reference Randell KM, Honkanen RJ, Komulainen MH, Tuppurainen MT, Kröger H, Saarikoski S (2001) Hormone replacement therapy and risk of falling in early postmenopausal women–a population-based study. Clin Endocrinol 54(6):769–774CrossRef Randell KM, Honkanen RJ, Komulainen MH, Tuppurainen MT, Kröger H, Saarikoski S (2001) Hormone replacement therapy and risk of falling in early postmenopausal women–a population-based study. Clin Endocrinol 54(6):769–774CrossRef
19.
go back to reference Greenland S (2015) Concepts and pitfalls in measuring and interpreting attributable fractions, prevented fractions, and causation probabilities. Ann Epidemiol 25(3):155–161CrossRef Greenland S (2015) Concepts and pitfalls in measuring and interpreting attributable fractions, prevented fractions, and causation probabilities. Ann Epidemiol 25(3):155–161CrossRef
20.
go back to reference Ryynänen O, Kivelä S, Honkanen R, Laippala P, Soini P (1991) Incidence of falling injuries leading to medical treatment in the elderly. Public Health 105(5):373–386CrossRef Ryynänen O, Kivelä S, Honkanen R, Laippala P, Soini P (1991) Incidence of falling injuries leading to medical treatment in the elderly. Public Health 105(5):373–386CrossRef
21.
go back to reference Lukkala PS, Honkanen RJ, Rauma PH, Williams LJ, Quirk SE, Kröger H, Koivumaa-Honkanen H (2016) Life satisfaction and morbidity among postmenopausal women. PLoS One 11(1):e0147521CrossRef Lukkala PS, Honkanen RJ, Rauma PH, Williams LJ, Quirk SE, Kröger H, Koivumaa-Honkanen H (2016) Life satisfaction and morbidity among postmenopausal women. PLoS One 11(1):e0147521CrossRef
22.
go back to reference Eggermont LH, Bean JF, Guralnik JM, Leveille SG (2009) Comparing pain severity versus pain location in the MOBILIZE Boston study: chronic pain and lower extremity function. J Gerontol A Biol Sci Med Sci 64((7):763–770CrossRef Eggermont LH, Bean JF, Guralnik JM, Leveille SG (2009) Comparing pain severity versus pain location in the MOBILIZE Boston study: chronic pain and lower extremity function. J Gerontol A Biol Sci Med Sci 64((7):763–770CrossRef
23.
go back to reference Leveille SG, Jones RN, Kiely DK, Hausdorff JM, Shmerling RH, Guralnik JM, Kiel DP, Lipsitz LA, Bean JF (2009) Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA 302(20):2214–2221CrossRef Leveille SG, Jones RN, Kiely DK, Hausdorff JM, Shmerling RH, Guralnik JM, Kiel DP, Lipsitz LA, Bean JF (2009) Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA 302(20):2214–2221CrossRef
24.
go back to reference Gates S, Fisher JD, Cooke MW, Carter YH, Lamb SE (2008) Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis. BMJ 336(7636):130–133CrossRef Gates S, Fisher JD, Cooke MW, Carter YH, Lamb SE (2008) Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis. BMJ 336(7636):130–133CrossRef
25.
go back to reference Smulders E, Schreven C, Weerdesteyn V, van den Hoogen FH, Laan R, Van Lankveld W (2009) Fall incidence and fall risk factors in people with rheumatoid arthritis. Ann Rheum Dis 68(11):1795–1796CrossRef Smulders E, Schreven C, Weerdesteyn V, van den Hoogen FH, Laan R, Van Lankveld W (2009) Fall incidence and fall risk factors in people with rheumatoid arthritis. Ann Rheum Dis 68(11):1795–1796CrossRef
26.
go back to reference Jamison M, Neuberger GB, Miller PA (2003) Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Care Res 49(5):673–680CrossRef Jamison M, Neuberger GB, Miller PA (2003) Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Care Res 49(5):673–680CrossRef
27.
go back to reference Ng CT, Tan MP (2013) Osteoarthritis and falls in the older person. Age Ageing 42(5):561–566CrossRef Ng CT, Tan MP (2013) Osteoarthritis and falls in the older person. Age Ageing 42(5):561–566CrossRef
28.
go back to reference Hoops ML, Rosenblatt NJ, Hurt CP, Crenshaw J, Grabiner MD (2012) Does lower extremity osteoarthritis exacerbate risk factors for falls in older adults? Womens Health 8(6):685–698 Hoops ML, Rosenblatt NJ, Hurt CP, Crenshaw J, Grabiner MD (2012) Does lower extremity osteoarthritis exacerbate risk factors for falls in older adults? Womens Health 8(6):685–698
29.
go back to reference Sturnieks DL, Tiedemann A, Chapman K, Munro B, Murray SM, Lord SR (2004) Physiological risk factors for falls in older people with lower limb arthritis. J Rheumatol 31(11):2272–2279PubMed Sturnieks DL, Tiedemann A, Chapman K, Munro B, Murray SM, Lord SR (2004) Physiological risk factors for falls in older people with lower limb arthritis. J Rheumatol 31(11):2272–2279PubMed
30.
go back to reference Cummings SR, Nevitt MC, Kidd S (1988) Forgetting falls. J Am Geriatr Soc 36(7):613–616CrossRef Cummings SR, Nevitt MC, Kidd S (1988) Forgetting falls. J Am Geriatr Soc 36(7):613–616CrossRef
Metadata
Title
Role of musculoskeletal disorders in falls of postmenopausal women
Authors
N. Afrin
R. Honkanen
H. Koivumaa-Honkanen
R. Sund
T. Rikkonen
L. Williams
H. Kröger
Publication date
01-11-2018
Publisher
Springer London
Published in
Osteoporosis International / Issue 11/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-018-4631-5

Other articles of this Issue 11/2018

Osteoporosis International 11/2018 Go to the issue