The association between fatigue severity and risk of falls among middle-aged and older Australian stroke survivors

Abstract

Background Fatigue is a common and often debilitating symptom experienced by many stroke survivors. Significant post stroke fatigue may predispose individuals to other health complications, such as falls, which can lead to fractures and soft tissue injuries. Only limited research has examined the association between fatigue and falls in stroke survivors. Methods Data were obtained from the Sax Institute’s 45 and Up Study, from a subset of individuals who had experienced a stroke. The Modified Fatigue Impact Scale—5-item version (MFIS-5) was used to measure the level of fatigue. A logistic regression model, adjusted for stroke characteristics and comorbidities, was used to determine the magnitude of association between change in fatigue score and odds of having had a fall. Results A total of 576 participants completed the questionnaire. A total of 214 (37.2%) participants reported having had a fall in the previous 12 months. There was a statistically significant association between fatigue scores and fall status (p < 0.001). Specifically, for every 1-point increase in the fatigue score (MFIS-5) (i.e. higher level of fatigue), the odds of a person having a fall is 1.10 times greater (AOR = 1.10; 95% CI 1.05, 1.15; p < 0.001). Conclusion This study revealed an association between an increasing risk of falls with increasing severity of post stroke fatigue. Accurate detection and management of fatigue may help reduce the risk of falls and should be the focus of future research.

Fracture Risk Increases After Stroke or Transient Ischemic Attack and Is Associated With Reduced Quality of Life

“…Fractures poststroke, similar to those in the general population, are often related to bone fragility and falls, which share overlapping and inter-related risk factors including the following: increased age, being female, preexisting osteoporosis, medications, atrial fibrillation, rheumatoid arthritis, fatigue, depression, reduced bone mineral density (BMD), impaired vision, cognitive impairment, previous falls or fractures, and greater stroke severity. 11–15 However, there is limited evidence of the change in the rate of fractures after neurological events, such as stroke. Evidence is also limited on the effects of fracture on health-related quality of life (HRQoL) after both stroke and transient ischemic attack (TIA).…”