Falls and EQ-5D rated quality of life in community-dwelling seniors with concurrent chronic diseases: a cross-sectional study

Abstract

BackgroundAlthough recommended for use in studies investigating falls in the elderly, the European Quality of Life Group instrument, EQ-5D, has not been widely used to assess the impact of falls on quality of life. The aim of this study was to investigate the association of single and frequent falls with EQ-5D rated quality of life in a sample of German community-dwelling seniors in primary care suffering a variety of concurrent chronic diseases and conditions.MethodsIn a cross-sectional study, a sample of community-dwelling seniors aged ≥ 72 years was interviewed by means of a standardised telephone interview. According to the number of self-reported falls within twelve months prior to interview, participants were categorised into one of three fall categories: no fall vs. one fall vs. two or more falls within twelve months. EQ-5D values as well as other characteristics were compared across the fall categories. Adjustments for a variety of concurrent chronic diseases and conditions and further variables were made by using multiple linear regression analysis, with EQ-5D being the target variable.ResultsIn total, 1,792 participants (median age 77 years; 53% female) were analysed. The EQ-5D differed between fall categories. Participants reporting no fall had a mean EQ-5D score of 81.1 (standard deviation [s.d.]: 15.4, median: 78.3), while participants reporting one fall (n = 265; 14.8%) and participants with two or more falls (n = 117; 6.5%) had mean total scores of 77.0 (s.d.: 15.8, median: 78.3; mean difference to participants without a fall: -4.1, p < 0.05) and 72.1 (s.d.: 17.6, median: 72.5; mean difference: -9.0, p < 0.05), respectively. The mean difference between participants with one fall and participants with two or more falls was -4.9 (p < 0.05). Under adjustment for a variety of chronic diseases and conditions, the mean decrease in the total EQ-5D score was about -1.0 score point for one fall and about -2.5 points for two or more falls within twelve months. In quantity, this decrease is comparable to other chronic diseases adjusted for. Among the variables with the greatest negative association with EQ-5D ratings in multivariate analysis were depression and fear of falling.ConclusionsThe findings suggest that falls are negatively associated with EQ-5D rated quality of life independent of a variety of chronic diseases and conditions.

The association between depressive symptoms and fall accidents among middle-aged and elderly people in China

“…Fall can cause adverse physical consequences such as fractures, restriction of active ability, deterioration of health, and decreased physical activity as well as reduced psychosocial consequences such as social isolation, low mode, and risk of institutionalization [7, 8]. Moreover, fall would have an important impact on subsequent disability, quality of life, and mortality [9, 10]. …”

Gender differences in physical activity patterns among older adults who fall

“…More than 30% of older adults aged 65 years and older and 50% of older adults aged 80 years and older fall each year (Stevens and Sogolow, 2008; Hammer, 2010; Soriano et al, 2007). Falls have a significant impact on subsequent disability, quality of life, and mortality (Finlayson and Peterson, 2010; Centers for Disease Control and Prevention and National Center for Injury Prevention and Control, 2014; Thiem et al, 2014). Older adults who fall once are two to three times more likely to fall again within the next six months (Stevens and Sogolow, 2008).…”

Association of falls with health-related quality of life (HRQOL) in older cancer survivors: A population based study

“…Although this is the first large study evaluating the impact of falls on quality of life in older cancer survivors, the results follow a similar pattern demonstrated in prior studies in the general elderly population. 14,15,24 A recent study of community-dwelling Medicare beneficiaries without cancer reported a negative impact of falls on the PCS (−5.57 points) as well as the MCS (−3.08 points) of the VR-12 health survey. 15 Moreover, the longitudinal decline in the HRQOL scores following falls are also similar to those reported in a prospective study in the general elderly population which showed a decline in follow-up SF-12 PCS and MCS scores suggesting that falls have negative physical as well as psychological impact.…”

“…Previous studies in older populations without cancer have shown a “dose-response” relationship between number of falls and HRQOL in which two or more falls are associated with greater decline compared to one fall. 24 Categories of cancer-specific variables available in this database such as cancer type, stage, time since diagnosis may not have enough detail to fully capture the impact of cancer on HRQOL. More detailed staging and treatment history (including chemotherapy type) should be included in future research evaluating association of falls with outcomes of older patients with cancer.…”