The association of glycemic control and fall risk in diabetic elderly: a cross-sectional study in Hong Kong

Abstract

Background Many foreign studies investigated glycemic control and fall risk. However, there was insufficient study on this topic in Hong Kong. This study aims to find out the association of glycemic control and fall risk in the diabetic elderly in a general outpatient clinic in the North District of Hong Kong. Their frequency of falls and other associated risk factors of fall were also studied. Methods A cross-sectional questionnaire survey was conducted on 442 diabetic patients aged 65 years-old or above with regular follow-up in a general outpatient clinic. Main outcome measure was the number of falls in the past one year from the interview date. Recurrent falls was defined as two or more falls in the past one year from the interview date. Subjects were asked about experience of hypoglycemic symptoms. HbA1c level, chronic illness, retinopathy etc. were obtained through computerized medical record review. Chi square test and logistic regression were used to assess the association between outcomes and the explanatory variables. Results In the past one year, 23.3% participants experienced at least one fall and 8.6% had recurrent falls. Hypoglycemic symptoms, and lower visual acuity < 0.6 were significantly associated with fall (OR 2.42, p = 0.007 and OR 1.75, p = 0.038 respectively). Age 75–79 years-old had a higher likelihood of fall than the 65–69 age group (OR 2.23, p = 0.044). Patients with HbA1c 7.0–7.4% had a lower risk of recurrent falls when compared to those with intensive control (OR 0.32, p = 0.044). Other risk factors that increased risk of recurrent falls were hypoglycemic symptoms (OR 6.64, p < 0.001) and history of cerebral vascular accident (OR 4.24, p = 0.003). Conclusions Hypoglycemic symptoms had a very strong association with falls. Less stringent HbA1c control reduced the risk of recurrent falls. Healthcare professionals need to take a more proactive approach in enquiring about hypoglycemia. There should be individualized diabetic treatment target for the diabetic elderly.

Validating the accuracy of the Hendrich II Fall Risk Model for hospitalized patients using the ROC curve analysis

“…The consideration of sex as a factor is essential in developing effective fall prevention strategies, as highlighted in this study and corroborated by others. [18][19][20] In the present study, most patients had a chronic disease, particularly hypertension, coronary artery disease, depression, hypoglycemic symptoms 21 or cancer, and were regularly taking medications for their chronic diseases. 17 These treatments may involve the use of medications, such as antidepressants, antipsychotics, benzodiazepines, diuretics, sedatives, and chemotherapy drugs, which could exacerbate the risk of falls in adult patients with chronic illnesses, leading to muscle weakness, poor balance, impaired proprioception, impaired cognition, and functional disabilities, particularly in the three units reflecting the highest HIIFRM fall scores.…”

A Prediction Algorithm For Fall Risk Assessment Among Community-Dwelling Elderly People

“…Moreover, underestimation of syncope-related falls can be suggested due to the retrograde amnesia for the loss of consciousness [24]. Concerning the 'diabetes' predictor, many studies confirm that older adults with diabetes mellitus are associated with greater risk of fall [25]. Declines in sensory function caused by diabetes-induced neuropathy or retinopathy may lead to an increased risk of falls [26].…”