Higher Fatigue Prospectively Increases the Risk of Falls in Older Men

Abstract

Background and Objectives Fatigue is a common complaint and shares many risk factors with falls, yet the independent contribution of fatigue on fall risk is unclear. This study’s primary aim was to assess the association between fatigue and prospective fall risk in 5,642 men aged 64-100 enrolled in the Osteoporotic Fractures in Men Study (MrOS). The secondary aim was to examine the association between fatigue and recurrent fall risk. Research Design and Methods Fatigue was measured at baseline using the Medical Outcomes Study (short form) single-item question “during the past four weeks, how much of the time did you feel energetic?” Responses were then classified: higher fatigue=“none”, “little”, or “some” of the time and lower fatigue=“a good bit”, “most”, or “all” of the time. We assessed falls using triannual questionnaires. Fall risk was examined prospectively over three years; recurrent falling was defined as ≥2 falls within the first year. Generalized estimating equations and multinomial logistic regression modeled prospective and recurrent fall risk as a function of baseline fatigue status, adjusted for demographics, medications, physical activity, and gait speed. Results Men with higher (26%) vs. lower baseline fatigue were older (75.1±6.2 vs.73.2±5.7 years), 24% less active, and had worse function (gait speed=1.09±0.24 vs. 1.24±0.21 m/s), all p<0.0001. Within one year, 25.4% (N=1,409) had fallen at least once, of which 47.4% (N=668) were recurrent fallers. Men with higher vs. lower fatigue had 25% increased fall risk (RR=1.25, 95% CI:1.14, 1.36) over 3 years follow-up, but had 50% increased odds of recurrent falling (OR 1.50, 95% CI: 1.22, 1.85) within the first year. Discussion and Implications Fatigue is an important risk factor of falling independent of established risk factors. Reductions in fatigue (i.e., increased energy) may lessen the burden of falls in older men and provide a novel avenue for fall risk intervention.

Declining energy predicts incident mobility disability and mortality risk in healthy older adults

“…Associations were robust to baseline SEL, demographic and health covariates, as well as self-reported tiredness, and volitional energy-related behaviors such as physical activity, appetite, or sleep. Our findings lend credence to the notion that SEL may be an early indicator of suboptimal aging 8,[25][26][27] and are the first to identify that SEL decline is associated with prospective clinically-relevant health outcomes. The current study further highlights the value of subjective perceptions to predict clinically-relevant outcomes.…”

Effect of Lower Limb Muscle Fatigue on Fall Risk for Transfemoral Amputee: A Pilot Study

“…As expected, the results revealed that the fall risk increased in both groups of subjects, but the significant differences between pre- and postfatigue only showed on TFA. These results are consistent with the current literature, which also reported that fatigue would increase the fall risk [ 6 , 8 , 24 ]. However, most of the risk factors associated with falls were based primarily on elderly patient cohorts and not on amputees.…”

Association Between Fatigue and Falls Risk Among the Elderly Aged Over 75 Years in China: The Chain Mediating Role of Falls Efficacy and Lower Limb Function

“…To our knowledge, very few studies have assessed the link between fatigue and risk of fall in community-dwelling older subjects. As expected, fatigue was a significant risk factor for falling in older population, as demonstrated by the previous study ( 39 ). The direct relationship between fatigue and falls risk we reported has been testified in a systematic review ( 5 ).…”

“…Current dwelling status Living alone 27 ( study (39). The direct relationship between fatigue and falls risk we reported has been testified in a systematic review (5).…”