Skip to main content
Erschienen in: Digestive Diseases and Sciences 10/2012

01.10.2012 | Original Article

Falls and Fall-Related Injury Are Common in Older People with Chronic Liver Disease

verfasst von: James Frith, Simon Kerr, Lisa Robinson, Chris S. Elliott, Katharine Wilton, David E. J. Jones, Christopher P. Day, Julia L. Newton

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

Improved survival with chronic liver disease (CLD) and increased incidence in the older has led to a rapidly expanding population which faces similar “geriatric syndromes” as the general population. With risk factors such as autonomic dysfunction, cognitive impairment, and muscle abnormalities in CLD it is expected that falls and injury will be common.

Aim

To determine prevalence of falls and injury in chronic liver disease and to identify potential modifiable fall associations.

Methods

Falls prevalence was estimated by providing patients aged ≥65 years with CLD a falls data collection tool, via the post or in the clinic. A younger CLD cohort and age-matched and sex-matched community controls was used for comparison. A sub-group underwent multidisciplinary falls assessment to identify modifiable fall associations.

Results

Falls were significantly more common in older people with CLD (47 % in previous year) than in controls; incidence of injury did not differ. Regression identified orthostatic symptoms, lower-limb strength, and fear of falling as being independently associated with falls in CLD. Those who had fallen had significantly greater difficulty with daily activities.

Conclusion

Falls are prevalent in older people with CLD, and are potentially preventable with multifactorial intervention. Services must prepare for expansion in the older CLD population; here we demonstrate how this expansion may affect falls services and provide a potential therapeutic target.
Literatur
1.
Zurück zum Zitat Office for National Statistics. Health Stat Q. 2008;40:59–60. Office for National Statistics. Health Stat Q. 2008;40:59–60.
2.
Zurück zum Zitat Regev A, Schiff ER. Liver disease in the elderly. Gastroenterol Clin N Am. 2001;30:547–563. Regev A, Schiff ER. Liver disease in the elderly. Gastroenterol Clin N Am. 2001;30:547–563.
3.
Zurück zum Zitat Amarapurkar D, Kamani P, Patel N, et al. Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6:161–163.PubMed Amarapurkar D, Kamani P, Patel N, et al. Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6:161–163.PubMed
4.
Zurück zum Zitat Potter J, James O. Clinical features and prognosis of alcoholic liver disease in respect of advancing age. Gerontology. 1987;33:380–387.PubMedCrossRef Potter J, James O. Clinical features and prognosis of alcoholic liver disease in respect of advancing age. Gerontology. 1987;33:380–387.PubMedCrossRef
5.
Zurück zum Zitat Parker D, Kingham J. Type 1 autoimmune hepatitis is primarily a disease of later life. QJM. 1997;90:289–296.PubMedCrossRef Parker D, Kingham J. Type 1 autoimmune hepatitis is primarily a disease of later life. QJM. 1997;90:289–296.PubMedCrossRef
7.
Zurück zum Zitat Newton JL, Davidson A, Kerr S, et al. Autonomic dysfunction in primary biliary cirrhosis correlates with fatigue severity. Eur J Gastroenterol Hepatol. 2007;19:125–132.PubMedCrossRef Newton JL, Davidson A, Kerr S, et al. Autonomic dysfunction in primary biliary cirrhosis correlates with fatigue severity. Eur J Gastroenterol Hepatol. 2007;19:125–132.PubMedCrossRef
8.
Zurück zum Zitat Hollingsworth KG, Newton JL, Taylor R, et al. Pilot study of peripheral muscle function in primary biliary cirrhosis: potential implications for fatigue pathogenesis. Clin Gastroenterol Hepatol. 2008;6:1041–1048.PubMedCrossRef Hollingsworth KG, Newton JL, Taylor R, et al. Pilot study of peripheral muscle function in primary biliary cirrhosis: potential implications for fatigue pathogenesis. Clin Gastroenterol Hepatol. 2008;6:1041–1048.PubMedCrossRef
9.
Zurück zum Zitat Pessayre D, Fromenty B, Mansouri A. Mitochondrial injury in steatohepatitis. Eur J Gastroenterol Hepatol. 2004;16:1095–1105.PubMedCrossRef Pessayre D, Fromenty B, Mansouri A. Mitochondrial injury in steatohepatitis. Eur J Gastroenterol Hepatol. 2004;16:1095–1105.PubMedCrossRef
10.
Zurück zum Zitat Newton JL, Hollingsworth KG, Taylor R, et al. Cognitive impairment in primary biliary cirrhosis: symptom impact and potential etiology. Hepatology. 2008;48:541–549.PubMedCrossRef Newton JL, Hollingsworth KG, Taylor R, et al. Cognitive impairment in primary biliary cirrhosis: symptom impact and potential etiology. Hepatology. 2008;48:541–549.PubMedCrossRef
11.
Zurück zum Zitat Fattakhova G, Jones D, Frith J, Day C, Newton J. Cognitive symptoms are prevalent in non-alcoholic fatty liver disease and unrelated to the severity of liver disease. Hepatology. 2009;50:S1029.CrossRef Fattakhova G, Jones D, Frith J, Day C, Newton J. Cognitive symptoms are prevalent in non-alcoholic fatty liver disease and unrelated to the severity of liver disease. Hepatology. 2009;50:S1029.CrossRef
12.
Zurück zum Zitat National Institute of Clinical Excellence. Clinical Practice Guideline for the Assessment and Prevention of Falls in Older People. London: Clinical Guideline 21; 2004. National Institute of Clinical Excellence. Clinical Practice Guideline for the Assessment and Prevention of Falls in Older People. London: Clinical Guideline 21; 2004.
13.
Zurück zum Zitat Schrezenmaier C, Gehrking JA, Hines SM, Low PA, Benrud-Larson LM, Sandroni P. Evaluation of orthostatic hypotension: relationship of a new self-report instrument to laboratory-based measures. Mayo Clin Proc. 2005;80:330–334.PubMedCrossRef Schrezenmaier C, Gehrking JA, Hines SM, Low PA, Benrud-Larson LM, Sandroni P. Evaluation of orthostatic hypotension: relationship of a new self-report instrument to laboratory-based measures. Mayo Clin Proc. 2005;80:330–334.PubMedCrossRef
14.
Zurück zum Zitat Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34:119–126.PubMed Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34:119–126.PubMed
15.
Zurück zum Zitat Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896–903.PubMed Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896–903.PubMed
16.
Zurück zum Zitat Yardley L, Beyer N, Hauer K, et al. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34:614–619. Yardley L, Beyer N, Hauer K, et al. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34:614–619.
17.
Zurück zum Zitat Lamb SE, Jorstad-Stein EC, Hauer K, Becker C, Prevention of Falls Network Europe and Outcomes Consensus G. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc. 2005;53:1618–1622.PubMedCrossRef Lamb SE, Jorstad-Stein EC, Hauer K, Becker C, Prevention of Falls Network Europe and Outcomes Consensus G. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc. 2005;53:1618–1622.PubMedCrossRef
18.
Zurück zum Zitat Soriano G, Román E, Córdoba J, et al. Cognitive dysfunction in cirrhosis is associated with falls. A prospective study. Hepatology. 2012. doi:10.1002/hep.25554. Soriano G, Román E, Córdoba J, et al. Cognitive dysfunction in cirrhosis is associated with falls. A prospective study. Hepatology. 2012. doi:10.​1002/​hep.​25554.
19.
Zurück zum Zitat Abraldes JG, Iwakiri Y, Loureiro-Silva M, Haq O, Sessa WC, Groszmann RJ. Mild increases in portal pressure upregulate vascular endothelial growth factor and endothelial nitric oxide synthase in the intestinal microcirculatory bed, leading to a hyperdynamic state. Am J Physiol Gastrointest Liver Physiol. 2006;290:G980–G987.PubMedCrossRef Abraldes JG, Iwakiri Y, Loureiro-Silva M, Haq O, Sessa WC, Groszmann RJ. Mild increases in portal pressure upregulate vascular endothelial growth factor and endothelial nitric oxide synthase in the intestinal microcirculatory bed, leading to a hyperdynamic state. Am J Physiol Gastrointest Liver Physiol. 2006;290:G980–G987.PubMedCrossRef
20.
Zurück zum Zitat Lhuillier F, Dalmas ED, Gratadour PM, et al. Spontaneous baroreflex cardiac sensitivity in end-stage liver disease: effect of liver transplantation. Eur J Anaesthesiol. 2006;23:426–432.PubMedCrossRef Lhuillier F, Dalmas ED, Gratadour PM, et al. Spontaneous baroreflex cardiac sensitivity in end-stage liver disease: effect of liver transplantation. Eur J Anaesthesiol. 2006;23:426–432.PubMedCrossRef
21.
Zurück zum Zitat Frith J, Newton J. Autonomic dysfunction in chronic liver disease. Liver Int. 2009;29:483–489.PubMedCrossRef Frith J, Newton J. Autonomic dysfunction in chronic liver disease. Liver Int. 2009;29:483–489.PubMedCrossRef
Metadaten
Titel
Falls and Fall-Related Injury Are Common in Older People with Chronic Liver Disease
verfasst von
James Frith
Simon Kerr
Lisa Robinson
Chris S. Elliott
Katharine Wilton
David E. J. Jones
Christopher P. Day
Julia L. Newton
Publikationsdatum
01.10.2012
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 10/2012
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-012-2193-5

Weitere Artikel der Ausgabe 10/2012

Digestive Diseases and Sciences 10/2012 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.