Incidence of falls among community‐dwelling older adults in Turkey and its relationship with pain and insomnia

Altintaş, Hülya Kulakçi; Aslan, Gülbahar Korkmaz

doi:10.1111/ijn.12766

Cited by 14 publications

(9 citation statements)

References 50 publications

(81 reference statements)

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“…Also, insomnia was not associated with falls when controlling for depressive symptoms. In the previous literature, most studies have found that insomnia was significantly associated with higher risk of falls in older adults [ 53 , 54 ]. Only one study has reported that there is no association between insomnia and falls [ 55 ], but this study included only older women.…”

Section: Discussionmentioning

confidence: 99%

Independent and synergistic effects of pain, insomnia, and depression on falls among older adults: a longitudinal study

Liu

Sun

et al. 2020

BMC Geriatr

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Background Few studies have examined the relationship between falls and pain, insomnia and depressive symptoms which are common and risk factors in older adults. We aimed to examine the independent and synergistic effects of these risk factors on future falls among older adults. Methods We used data of 2558 community-dwelling older adults from 2011 (Y1) to 2015 (Y5) of the National Health and Aging Trends Study (NHATS). Pain was determined by whether participants reported bothersome pain in the last month. Insomnia was assessed by two questions about how often the participants had trouble falling asleep and maintaining sleep. Depressive symptoms were assessed by Patient Health Questionnaire-2. Generalized estimation equation (GEE) models were used to examine the independent effects of pain, insomnia and depressive symptoms at prior-wave (period y-1) on falls at current wave (period y) adjusting for covariates (age, sex, education, race/ethnicity, living arrangement, BMI, smoking, vigorous activities, number of chronic illnesses and hospitalization). The significance of the three-way interaction of these factors (pain*insomnia*depression) was tested using the aforementioned GEE models to determine their synergistic effects on falls. Results Overall, the participants were mainly 65–79 years old (68%), female (57%) and non-Hispanic White (70%). At Y1, 50.0% of the participants reported pain, 22.6% reported insomnia and 9.9% reported depressive symptoms. The incidence of falls from Y2 to Y5 was 22.4, 26.0, 28.3, and 28.9%, respectively. Participants with pain (Odds ratio [OR], 95% confidence interval [CI] = 1.36, 1.23–1.50) and depressive symptoms (OR, 95% CI = 1.43, 1.23–1.67) had high rates of falling adjusting for covariates. After further adjustment for insomnia and depressive symptoms, pain independently predicted falls (OR, 95% CI = 1.36, 1.22–1.51). Depressive symptoms also independently predicted falls after further adjusting for pain and insomnia (OR, 95% CI = 1.40, 1.20–1.63). After adjusting for pain and depression, the independent effects of insomnia were not significant. None of the interaction terms of the three risk factors were significant, suggesting an absence of their synergistic effects. Conclusions Pain and depressive symptoms independently predict falls, but synergistic effects seem absent. Further research is needed to develop effective strategies for reducing falls in older adults, particularly with pain and depressive symptoms.

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Section: Discussionmentioning

confidence: 99%

Independent and synergistic effects of pain, insomnia, and depression on falls among older adults: a longitudinal study

Liu

Sun

et al. 2020

BMC Geriatr

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“…Our study also found that waking up frequently during the night increased the risk of falls in elderly people with visual impairment. Previous studies have reported that subjective poor sleep quality ( 17 ), napping ( 18 ), short sleep duration ( 19 , 20 ), long sleep duration ( 20 ), and insomnia ( 21 ) were associated with an increased risk of falls and fractures ( 22 , 23 ). Waking up frequently at night is one kind of sleep disorders that reduce sleep quality ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Risk factors of falls in elderly patients with visual impairment

Ouyang

Zheng

Lin

et al. 2022

Front. Public Health

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ObjectiveTo examine the risk factors for falls in elderly patients with visual impairment (VI) and assess the predictive performance of these factors.MethodsBetween January 2019 and March 2021, a total of 251 elderly patients aged 65–92 years with VI were enrolled and then prospectively followed up for 12 months to evaluate outcomes of accidental falls via telephone interviews. Information of demographics and lifestyle, gait and balance deficits, and ophthalmic and systemic conditions were collected during baseline visits. Forward stepwise multivariable logistic regression analysis was performed to identify independent risk factors of falls in elderly patients with VI, and a derived nomogram was constructed.ResultsA total of 143 falls were reported in 251 elderly patients during follow-up, with an incidence of 56.97%. The risk factors for falls in elderly patients with VI identified by multivariable logistic regression were women [odds ratio (OR), 95% confidence interval (CI): 2.71, 1.40–5.27], smoking (3.57, 1.34–9.48), outdoor activities/3 months (1.31, 1.08–1.59), waking up frequently during the night (2.08, 1.15–3.79), disorders of balance and gait (2.60, 1.29–5.24), glaucoma (3.12, 1.15–8.44), other retinal degenerations (3.31, 1.16–9.43) and best-corrected visual acuity (BCVA) of the better eye (1.79, 1.10–2.91). A nomogram was developed based on the abovementioned multivariate analysis results. The area under receiver operating characteristic curve of the predictive model was 0.779.ConclusionsGender, smoking, outdoor activities, waking up at night, disorders of balance and gait, glaucoma, other retinal degeneration and BCVA of the better eye were independent risk factors for falls in elderly patients with VI. The predictive model and derived nomogram achieved a satisfying prediction of fall risk in these individuals.

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“…A large earlier study by Holmberg et al [27] of 22,444 men, mean age 44 years, and 10,902 women, mean age 50 years with a follow-up of to 16 years with regard to occurrence of fracture found 135 women had one low-energy hip fracture each, and 166 in men. Among the significant predictors, were reported sleep disturbances, an observation supported by Bakken et al [19] for adults who take drugs to reduce sleep disturbances, Kulukci et al for older adults with chronic pain [28], and Kanis et al [29]. As well, Yoshimura et al [30] who conducted a prospective study among Japanese adults that examined hip fracture determinants found these to include sleep disturbance, sleeping in a Western-style bed, and drinking more than three cups of coffee daily, which could hamper sleep.…”

Section: Resultsmentioning

confidence: 87%

Sleep Disturbances and Hip Fractures

Marks

2020

JARH

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Hip fractures, which remain highly prevalent among the elderly and produce enormous social and economic costs, have not truly abated in prevalence despite years of research that outlines a multitude of preventable risk factors and intervention programs. This review aimed to examine if sleep disturbances have a bearing on the risk of incurring a hip fracture directly or indirectly, among older adults. The specific aim was to explore and summarize what we know, and how this might inform future research and practice. To this end, PUBMED, Web of Science, Scopus, and Google Scholar data bases were searched to uncover available data representing the topic of sleep in relation to hip fractures among the elderly. Articles of note were scrutinized and summarized in narrative form. Results showed very few studies on the topic prevail, even with no restriction on years examined, and of these, discordant, rather than any solid uniform conclusions prevail. It is concluded there is a need to explore this topic carefully, including both the direct, as well as the indirect impact of sleep that may place an older adult at heightened risk for a fall and hip fracture injury as well as subsequent fractures.

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Incidence of falls among community‐dwelling older adults in Turkey and its relationship with pain and insomnia

Cited by 14 publications

References 50 publications

Independent and synergistic effects of pain, insomnia, and depression on falls among older adults: a longitudinal study

Independent and synergistic effects of pain, insomnia, and depression on falls among older adults: a longitudinal study

Risk factors of falls in elderly patients with visual impairment

Sleep Disturbances and Hip Fractures

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