Patterns in Health-related Behaviours and Fall Injuries Among Older People: a Population-based Study in Stockholm County, Sweden

Overview

Journal Age Ageing

Publisher Oxford University Press

Specialty Geriatrics

Date 2015 Apr 24

PMID 25904445

Citations 5

Authors

Bjorg Helgadottir

Jette Moller

Lucie Laflamme

Affiliations

Soon will be listed here.

Abstract

Aim: we identified clusters of older people with similar health-related behaviours and assessed the association between those clusters and the risk of injurious fall.

Methods: we linked self-reported and register-based data on the over-65s from the Stockholm public health cohort (N = 20,212). Groups of people with similar health-related behaviours were identified by cluster analysis using four measures of physical activity, two of smoking and alcohol habits and two individual attributes (age and type of housing). The association between clusters and falls leading to hospitalisation (422 cases) was studied using a nested case-control design. Odds ratios (ORs), crude and adjusted for health status, were compiled by cluster using the one with the most 'protective' health behaviour profile as the reference.

Results: five clusters were identified revealing a variety of combinations of health-related behaviours, all linked to specific age groups and types of housing and with a tendency towards higher levels of physical activity among the younger ones. The risk of injurious falls differed across clusters, and for three out of four, it was significantly higher than in the comparison cluster. Adjusting for health status only partially reduced the ORs for those clusters and this was observed both in men and women.

Conclusion: health-related behaviours aggregate in different manners among older people. Some health-related profiles are associated with an excess risk of falls leading to hospitalisation. Although this is partly a reflection of age differences across clusters, health status alone cannot fully explain the association.

Citing Articles

Understanding the Association of Older Adult Fall Risk Factors by Age and Sex Through Factor Analysis.

Kakara R, Bergen G, Burns E J Appl Gerontol. 2023; 42(7):1662-1671.

PMID: 36724197 PMC: 10258133. DOI: 10.1177/07334648231154881.

Co-occurrences of fall-related factors in adults aged 60 to 85 years in the United States National Health and Nutrition Examination Survey.

Rietdyk S, Ambike S, Amireault S, Haddad J, Lin G, Newton D PLoS One. 2022; 17(11):e0277406.

PMID: 36346815 PMC: 9642892. DOI: 10.1371/journal.pone.0277406.

Association between falls in elderly and the number of chronic diseases and health-related behaviors based on CHARLS 2018: health status as a mediating variable.

Tang S, Liu M, Yang T, Ye C, Gong Y, Yao L BMC Geriatr. 2022; 22(1):374.

PMID: 35484497 PMC: 9047259. DOI: 10.1186/s12877-022-03055-x.

Risk Profiles for Injurious Falls in People Over 60: A Population-Based Cohort Study.

Ek S, Rizzuto D, Fratiglioni L, Johnell K, Xu W, Welmer A J Gerontol A Biol Sci Med Sci. 2017; 73(2):233-239.

PMID: 28605455 PMC: 5861922. DOI: 10.1093/gerona/glx115.

Usual Alcohol Consumption and Risks for Nonfatal Fall Injuries in the United States: Results From the 2004-2013 National Health Interview Survey.

Chen C, Yoon Y Subst Use Misuse. 2017; 52(9):1120-1132.

PMID: 28524713 PMC: 6080198. DOI: 10.1080/10826084.2017.1293101.

References

Malmivaara A, Heliovaara M, Knekt P, Reunanen A, Aromaa A . Risk factors for injurious falls leading to hospitalization or death in a cohort of 19,500 adults. Am J Epidemiol. 1993; 138(6):384-94. DOI: 10.1093/oxfordjournals.aje.a116871. View

Frick Bergstrom M, Byberg L, Melhus H, Michaelsson K, Gedeborg R . Extent and consequences of misclassified injury diagnoses in a national hospital discharge registry. Inj Prev. 2010; 17(2):108-13. DOI: 10.1136/ip.2010.028951. View

Law M, Hackshaw A . A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect. BMJ. 1997; 315(7112):841-6. PMC: 2127590. DOI: 10.1136/bmj.315.7112.841. View

Selway J, Soderstrom C, Kufera J . Alcohol use and testing among older trauma victims in Maryland. J Trauma. 2008; 65(2):442-6. DOI: 10.1097/TA.0b013e31817c553b. View

Kirchner J, Zubritsky C, Cody M, Coakley E, Chen H, Ware J . Alcohol consumption among older adults in primary care. J Gen Intern Med. 2007; 22(1):92-7. PMC: 1824716. DOI: 10.1007/s11606-006-0017-z. View

Helgadottir B, Laflamme L, Monarrez-Espino J, Moller J . Medication and fall injury in the elderly population; do individual demographics, health status and lifestyle matter?. BMC Geriatr. 2014; 14:92. PMC: 4150120. DOI: 10.1186/1471-2318-14-92. View

Kannus P, Sievanen H, Palvanen M, Jarvinen T, Parkkari J . Prevention of falls and consequent injuries in elderly people. Lancet. 2005; 366(9500):1885-93. DOI: 10.1016/S0140-6736(05)67604-0. View

Rubenstein L . Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006; 35 Suppl 2:ii37-ii41. DOI: 10.1093/ageing/afl084. View

Kanis J, Johnell O, Oden A, Johansson H, De Laet C, Eisman J . Smoking and fracture risk: a meta-analysis. Osteoporos Int. 2004; 16(2):155-62. DOI: 10.1007/s00198-004-1640-3. View

10.

Robertson M, Campbell A, Gardner M, Devlin N . Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc. 2002; 50(5):905-11. DOI: 10.1046/j.1532-5415.2002.50218.x. View

11.

Iinattiniemi S, Jokelainen J, Luukinen H . Exercise and risk of injurious fall in home-dwelling elderly. Int J Circumpolar Health. 2008; 67(2-3):235-44. DOI: 10.3402/ijch.v67i2-3.18279. View

12.

Ribbe M, Ljunggren G, Steel K, Topinkova E, Hawes C, IKEGAMI N . Nursing homes in 10 nations: a comparison between countries and settings. Age Ageing. 1998; 26 Suppl 2:3-12. DOI: 10.1093/ageing/26.suppl_2.3. View

13.

Karlsson M, Nordqvist A, Karlsson C . Physical activity, muscle function, falls and fractures. Food Nutr Res. 2009; 52. PMC: 2615636. DOI: 10.3402/fnr.v52i0.1920. View

14.

Barnes A, Moore A, Xu H, Ang A, Tallen L, Mirkin M . Prevalence and correlates of at-risk drinking among older adults: the project SHARE study. J Gen Intern Med. 2010; 25(8):840-6. PMC: 2896609. DOI: 10.1007/s11606-010-1341-x. View

15.

Gregg E, Pereira M, Caspersen C . Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence. J Am Geriatr Soc. 2000; 48(8):883-93. DOI: 10.1111/j.1532-5415.2000.tb06884.x. View

16.

Walsh J, Pressman A, Cauley J, Browner W . Predictors of physical activity in community-dwelling elderly white women. J Gen Intern Med. 2001; 16(11):721-7. PMC: 1495288. DOI: 10.1111/j.1525-1497.2001.00506.x. View

17.

Drake M, Murad M, Mauck K, Lane M, Undavalli C, Elraiyah T . Clinical review. Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2012; 97(6):1861-70. DOI: 10.1210/jc.2011-3058. View

18.

Felson D, Zhang Y, Hannan M, Kannel W, Kiel D . Alcohol intake and bone mineral density in elderly men and women. The Framingham Study. Am J Epidemiol. 1995; 142(5):485-92. DOI: 10.1093/oxfordjournals.aje.a117664. View

19.

Blain H, Carriere I, Sourial N, Berard C, Favier F, Colvez A . Balance and walking speed predict subsequent 8-year mortality independently of current and intermediate events in well-functioning women aged 75 years and older. J Nutr Health Aging. 2010; 14(7):595-600. DOI: 10.1007/s12603-010-0111-0. View

20.

Hippisley-Cox J, Coupland C . Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ. 2009; 339:b4229. PMC: 2779855. DOI: 10.1136/bmj.b4229. View