The online version of this article (doi:10.1186/1471-2318-14-22) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
KMS conceived of the study, designed the study, obtained ethics approval, conducted the analysis and wrote the manuscript. JV participated in study design, data analysis and interpretation, and manuscript writing. SEM participated in study design, data analysis and interpretation, and manuscript writing. SES participated in data analysis and interpretation and contributed to manuscript writing. SBJ participated in study conception, design, analysis interpretation and manuscript writing. All authors read and approved the final manuscript.
Falls and chronic disease are both important health issues in older adults. The objectives of this study were to quantify the prevalence of falls and multi-morbidity (≥2 chronic conditions) in Canadian older adults; examine associations between falls and number of chronic conditions; and explore whether certain patterns of chronic disease were associated with a greater risk of falling.
Data were derived from the Canadian Community Health Survey- Healthy Aging. Primary outcomes from 16,357 community-dwelling adults aged 65 years and over were self-reported falls in the previous 12 months and presence of 13 chronic conditions. Prevalence estimates were calculated with normalized sampling weights, and hierarchical cluster analysis was used to identify clusters based on chronic condition patterns, and tested for association to falls with logistic regression.
Overall prevalence of falling and multi-morbidity were 19.8% and 62.0% respectively. Fall risk was significantly greater in individuals with one, two, four, five and six or more chronic conditions relative to those with none (all p < 0.05). A seven-cluster model was selected, including groups with low prevalence of chronic disease, or high prevalence of hypertension and arthritis, visual impairment, hypertension, chronic obstructive pulmonary disease (COPD), diabetes, or heart disease and hypertension. Only the hypertension cluster (Odds Ratio [OR] = 1.2) and COPD cluster (OR = 1.6) were significantly associated with increased falls relative to the low prevalence group.
Both the number and pattern of chronic conditions were related to falls. COPD emerged as a significant predictor of falls despite affecting a smaller proportion of respondents. Continued study is warranted to verify this association and determine how to incorporate consideration of chronic disease and multi-morbidity into fall risk assessments.
Additional file 1: Dendogram illustrating the seven-group cluster solution selected for the present study (circles), using Ward’s minimum variance method. The dendogram illustrates relationships of dissimilarity (reflected by the semi-partial r-squared of the Jaccard dissimiliarity coefficient, vertical axis) from 16,357 individuals (horizontal axis) based on their patterns of binary response to eleven self-reported chronic conditions (excluding Parkinson’s disease and Dementia). (DOCX 50 KB)
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- Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions
Kathryn M Sibley
Sarah E Munce
Sharon E Straus
Susan B Jaglal
- BioMed Central
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