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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Research article

Factors associated with screening positive for high falls risk in fragility fracture patients: a cross-sectional study

Authors: Nooshin K. Rotondi, Dorcas E. Beaton, Rebeka Sujic, Earl Bogoch, Taucha Inrig, Denise Linton, Jennifer Weldon, Ravi Jain, Joanna E. M. Sale

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

We sought to report the prevalence of fragility fracture patients who were screened at high falls risk using a large provincial database, and to determine the characteristics associated with being screened at high falls risk.

Methods

The study population included fragility fracture patients 50+ years of age who were screened at 35 hospital fracture clinics in Ontario over a 3.5 year period. The outcome was based on two screening questions measuring the risk of falling, both adapted from the STEADI (Stopping Elderly Accidents, Deaths & Injuries) tool. Multivariable associations of sociodemographic, fracture-related, and health-related characteristics were evaluated using logistic regression.

Results

Of the sample, 9735 (44.5%) patients were classified as being at high falls risk, and 12,089 (55.3%) were not. In the multivariable logistic regression, being 80+ years of age (vs. 50–64 years of age), non-community dwelling (vs. living with spouse, family member, roommate), having a mental/physical impairment (vs. none), and taking multiple medications, were all strongly associated with being screened at high falls risk.

Conclusions

Living in a non-community dwelling and taking 4+ medications were the variables most strongly associated with being screened at high falls risk. These are potentially modifiable characteristics that should be considered when assessing falls risk in fragility fracture patients, and particularly when designing interventions for preventing subsequent falls. Ongoing work to address the higher risk of falls in the fragility fracture population is warranted.
Literature
1.
Dewan N, MacDermid J, Grewal R, Beattie K. Risk factors predicting subsequent falls and osteoporotic fractures at 4 years after distal radius fracture-a prospective cohort study. Arch Osteoporos. 2018;13:32.CrossRefPubMed
2.
Chang V, Do M. Risk factors for falls among seniors: implications of gender. Am J Epidemiol. 2015;181:521–31.CrossRefPubMed
3.
Ambrose A, Cruz L, Paul G. Falls and fractures: a systematic approach to screening and prevention. Maturitas. 2015;82:85–93.CrossRefPubMed
4.
Tinetti ME, Gordon C, Sogolow E, Lapin P, Bradley EH. Fall-risk evaluation and management: challenges in adopting geriatric care practices. Gerontologist. 2006;46:717–25.CrossRefPubMed
5.
6.
Smulders E, Van LW LR, Duysens J, Weerdesteyn V. Does osteoporosis predispose falls? A study on obstacle avoidance and balance confidence. BMC Musculoskelet Disord. 2011;12:1.CrossRefPubMedPubMedCentral
7.
Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35:ii37–41.CrossRefPubMed
8.
Einsiedel T, Becker C, Stengel D, Schmelz A, Kramer M, Daxle M, Lechner F, Kinzl L, Gebhard F. Do injuries of the upper extremity in geriatric patients end up in helplessness? A prospective study for the outcome of distal radius and proximal humerus fractures in individuals over 65. Z Gerontol Geriatr. 2006;39:451–61.CrossRefPubMed
9.
Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ. 2010;182:1864–73.CrossRefPubMedPubMedCentral
10.
Edwards BJ, Song J, Dunlop DD, Fink HA, Cauley JA. Functional decline after incident wrist fractures--study of osteoporotic fractures: prospective cohort study. BMJ. 2010;341:c3324.CrossRefPubMedPubMedCentral
11.
Russell MA, Hill KD, Blackberry I, Day LL, Dharmage SC. Falls risk and functional decline in older fallers discharged directly from emergency departments. J Gerontol A Biol Sci Med Sci. 2006;61:1090–5.CrossRefPubMed
12.
Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301:513–21.CrossRefPubMed
13.
Deandrea S, Lucenteforte E, Bravi F, Foschi R, La VC, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiol. 2010;21:658–68.CrossRef
14.
15.
Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare population. Am J Prev Med. 2012;43:59–62.CrossRefPubMed
16.
Lawlor DA, Patel R, Ebrahim S. Association between falls in elderly women and chronic diseases and drug use: cross sectional study. BMJ. 2003;327:712–7.CrossRefPubMedPubMedCentral
17.
Helgadottir B, Laflamme L, Monarrez-Espino J, Moller J. Medication and fall injury in the elderly population; do individual demographics, health status and lifestyle matter? BMC Geriatr. 2014;14:92.CrossRefPubMedPubMedCentral
18.
Munson JC, Bynum JP, Bell JE, Cantu R, McDonough C, Wang Q, Tosteson TD, Tosteson AN. Patterns of prescription drug use before and after fragility fracture. JAMA Intern Med. 2016;176:1531–8.CrossRefPubMedPubMedCentral
19.
Freeland KN, Thompson AN, Zhao Y, Leal JE, Mauldin PD, Moran WP. Medication use and associated risk of falling in a geriatric outpatient population. Ann Pharmacother. 2012;46:1188–92.CrossRefPubMed
20.
21.
Hartikainen S, Lonnroos E, Louhivuori K. Medication as a risk factor for falls: critical systematic review. J Gerontol A Biol Sci Med Sci. 2007;62:1172–81.CrossRefPubMed
22.
23.
Campbell AJ, Robertson MC. Implementation of multifactorial interventions for fall and fracture prevention. Age Ageing. 2006;35:ii60–4.CrossRefPubMed
24.
25.
Menant JC, Close JC, Delbaere K, Sturnieks DL, Trollor J, Sachdev PS, Brodaty H, Lord SR. Relationships between serum vitamin D levels, neuromuscular and neuropsychological function and falls in older men and women. Osteoporos Int. 2012;23:981–9.CrossRefPubMed
26.
27.
Pluijm SM, Smit JH, Tromp EA, Stel VS, Deeg DJ, Bouter LM, Lips P. A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporos Int. 2006;17:417–25.CrossRefPubMed
28.
Jaglal SB, Hawker G, Cameron C, Canavan J, Beaton D, Bogoch E, Jain R, Papaioannou A. The Ontario osteoporosis strategy: implementation of a population-based osteoporosis action plan in Canada. Osteoporos Int. 2010;21:903–8.CrossRefPubMedPubMedCentral
29.
Kannus P, Sievanen H, Palvanen M, Jarvinen T, Parkkari J. Prevention of falls and consequent injuries in elderly people. Lancet. 2005;366:1885–93.CrossRefPubMed
30.
Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, Bessant J, Brown JP. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int. 2008;19:79–86.CrossRefPubMed
31.
32.
33.
SAS software, Version 9.4. Copyright © 2013. Cary; SAS Institute Inc.; 2013.
34.
Lohman MC, Crow RS, DiMilia PR, Nicklett EJ, Bruce ML, Batsis JA. Operationalisation and validation of the stopping elderly accidents, deaths, and injuries (STEADI) fall risk algorithm in a nationally representative sample. J Epidemiol Community Health. 2017;71:1191–7.PubMedPubMedCentral
35.
Albert SM, King J, Boudreau R, Prasad T, Lin CJ, Newman AB. Primary prevention of falls: effectiveness of a statewide program. Am J Public Health. 2014;104:e77–84.CrossRefPubMedPubMedCentral
36.
Casey CM, Parker EM, Winkler G, Liu X, Lambert GH, Eckstrom E. Lessons learned from implementing CDC's STEADI falls prevention algorithm in primary care. Gerontologist. 2016;57:787–96.PubMed
37.
Lloyd BD, Williamson DA, Singh NA, Hansen RD, Diamond TH, Finnegan TP, Allen BJ, Grady JN, Stavrinos TM, Smith EU, Diwan AD, Fiatarone Singh MA. Recurrent and injurious falls in the year following hip fracture: a prospective study of incidence and risk factors from the sarcopenia and hip fracture study. J Gerontol A Biol Sci Med Sci. 2009;64:599–609.CrossRefPubMed
38.
Shumway-Cook A, Ciol MA, Gruber W, Robinson C. Incidence of and risk factors for falls following hip fracture in community-dwelling older adults. Phys Ther. 2005;85:648–55.CrossRefPubMed
39.
40.
Zia A, Kamaruzzaman SB, Tan MP. Polypharmacy and falls in older people: balancing evidence-based medicine against falls risk. Postgrad Med. 2015;127:330–7.CrossRefPubMed
41.
Stevens JA, Phelan EA. Development of STEADI: a fall prevention resource for health care providers. Health Promot Pract. 2013;14:706–14.CrossRefPubMed
42.
Stevens JA. The STEADI tool kit: a fall prevention resource for health care providers. IHS Prim Care Provid. 2013;39:162–6.PubMedPubMedCentral
43.
Garcia PA, Dias JMD, Silva SLA, Dias RC. Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement. Braz J Phys Ther. 2015;19(3):218–26.CrossRefPubMedPubMedCentral
44.
Lawson SN, Zaluski N, Petrie A, Arnold C, Basran J, Bello-Haas VD. Validation of the Saskatoon falls prevention Consortium's falls screening and referral algorithm. Physiother Can. 2013;65(1):31–9.CrossRefPubMedPubMedCentral
45.
Grossman DC, Curry SJ, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW Jr, Kemper AR, Krist AH, Kubik M, Landefeld S, Mangione CM, Pignone M, Silverstein M, Simon MA, Tseng CW. Interventions to prevent falls in community-dwelling older adults: US preventive services task force recommendation statement. JAMA. 2018;319:1696–704.CrossRefPubMed
Metadata
Title
Factors associated with screening positive for high falls risk in fragility fracture patients: a cross-sectional study
Authors
Nooshin K. Rotondi
Dorcas E. Beaton
Rebeka Sujic
Earl Bogoch
Taucha Inrig
Denise Linton
Jennifer Weldon
Ravi Jain
Joanna E. M. Sale
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03410-2

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