Falls in older people with diabetes: Identification of simple screening measures and explanatory risk factors

Abstract

Aims: To identify risk factors for falls in older people with diabetes mellitus (DM) and to develop a low-cost fall risk screening tool.Methods: Older adults with DM (n=103; age=61.6+6.0years) were recruited from diabetic clinics. Demographic, DM specific factors, lower limb strength and sensation, cognition, fear of falling, hand reaction time, balance, mobility and gait parameters were assessed using validated methods. Falls were prospectively recorded over six months.Results: Past falls and female gender were identified as significant predictors of falls: history of falls and female gender increased fall rates by 4.62 (95% CI = 2.31 to 9.27) and 2.40 (95% CI = 1.04 to 5.54) respectively. Fall rates were significantly associated with Diabetic Neuropathy scores, HbA1c level, contrast sensitivity, quadriceps strength, postural sway, tandem balance, stride length and Timed Up and Go Test times. A multi-variable fall risk tool derived using five measures, revealed that absolute risk for multiple falls increased from 0% in participants with zero or one factor to 83% in participants with all five risk factors. Conclusions:Simple screening items for fall risk in people with DM were identified, with parsimonious explanatory risk factors. These findings help guide tailored interventions for preventing falls in DM.

Risk of Fall among Chronic Type 2 Diabetes Mellitus Patients in Lahore: A Case Series

“…Anoter research reported that female gender increases the risk by 4.62%. 25 Results of our study concluded that majority of the patients (55.95) were at medium risk of fall. Our research findings were similar to another study which reported 84% were at medium risk of fall and 15% were at mild risk of fall among total 196 diabetic patients.…”

Influence of age on static postural control in adults with type 2 diabetes mellitus: a cross-sectional study

“…Wettasinghe et al. reported that increased postural sway with eyes open and closed was significantly associated with falls ( 33 ). Most postural sway parameters in the older age group were significantly higher than those in the relatively younger group from this study.…”

Cutaneous and muscular afferents from the foot and sensory fusion processing: Physiology and pathology in neuropathies

“…202 In a recent assessment centred on balance and falls, three fourths of multiple-faller patients had a diagnosis of neuropathy. 203 These exhibited objectively increased body sway with or without vision, standing on solid ground or foam, and walking speed was slower than in patients who did not fall. In this regard, it has been found in a study that recruited patients of different age groups that the tactile pressure sensitivity threshold increases significantly across the entire foot sole with age, with the larger loss of sensitivity at the heel than at the forefoot.…”