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Lin WQ, Lin L, Sun SY, Yuan LX, Sun MY, Wang C, Chen JM, Li YH, Zhou Q, Wu D, Huang TY, Liang BH, Liu H. Prevalence of falls, injury from falls and associations with chronic diseases among community-dwelling older adults in Guangzhou, China: a cross-sectional study. Front Public Health 2023; 11:1251858. [PMID: 37780423 PMCID: PMC10540617 DOI: 10.3389/fpubh.2023.1251858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction As a developing country with the largest older adult population in the world, strengthening the research on falls among the older adults is undoubtedly an urgent item in China. This study aimed to explore the prevalence and risk factors associated with falls and injury from falls among community-dwelling older adults in Guangzhou, China, particularly focusing on their associations with chronic diseases. Methods A total of 1,629 participants aged 65 years and above were selected from 11 counties in Guangzhou by the multi-stage stratified random sampling method in 2021. Socio-demographic characteristics, health and lifestyle factors, the status of falls, and injury from falls were measured by structured questionnaires through face-to-face interviews. Chi-square tests and logistic regression analysis were used to identify factors associated with falls and injury from falls. Chord diagrams were used to explore their associations with chronic diseases. Results A total of 251 participants (15.41%, 95% CI: 13.98%-17.25%) reported falls, and 162 participants (9.46%, 95% CI:7.72%-11.55%) indicated an injury from falls. Logistic regression analysis showed the results as follows: female patients (adjusted OR = 1.721, 95% CI: 1.681-1.761) aged ≥80 years (1.910, 1.847-1.975), unemployed (1.226, 1.171-1.284), uninsured (1.555, 1.448-1.671), average monthly household income of 2,001-4,000 CNY (1.878, 1.827-1.930), number of services provided by the community health center ≥13 times per year (1.428, 1.383-1.475), illness within 2 weeks (1.633, 1.595-1.672), high-intensity physical activity (2.254, 2.191-2.32), sedentary (1.094, 1.070-1.117), and number of chronic disease illnesses ≥3 (1.930, 1.870-1.993). Meanwhile, those risk factors were also associated with injury from falls. The older adults with medium-intensity physical activity were at lower risk (0.721, 0.705-0.737) of falls and higher risk (1.086, 1.057-1.117) of being injured from falls. Chord diagrams showed the correlations between chronic diseases and falls and injury from falls among community-dwelling older adults in Guangzhou, China. Conclusion The high prevalence of falls is found among community-dwelling older adults in Guangzhou, China, which is related to multiple factors such as demographic variables, lifestyle, and health status, especially for chronic diseases. Therefore, targeted interventions should be developed and implemented urgently.
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Affiliation(s)
- Wei-Quan Lin
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Lin Lin
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Si-Yu Sun
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Le-Xin Yuan
- Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
| | - Min-Ying Sun
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Chang Wang
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
| | - Jia-Min Chen
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
| | - Yao-Hui Li
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
| | - Qin Zhou
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
| | - Di Wu
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Department of Prevention and Control of Chronic Noncommunicable Diseases, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
| | - Ting-Yuan Huang
- Department of Prevention and Control of Chronic Noncommunicable Diseases, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
| | - Bo-Heng Liang
- Department of Prevention and Control of Chronic Noncommunicable Diseases, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
| | - Hui Liu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, China
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Cheng Z, Li X, Xu H, Bao D, Mu C, Xing Q. Incidence of accidental falls and development of a fall risk prediction model among elderly patients with diabetes mellitus: A prospective cohort study. J Clin Nurs 2023; 32:1398-1409. [PMID: 35596277 DOI: 10.1111/jocn.16371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/15/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022]
Abstract
AIMS To investigate the incidence of accidental falls and develop a fall risk prediction tool in elderly patients with diabetes mellitus. BACKGROUND The risk of fall in elderly patients with diabetes is higher than that in the general elderly, there is fewer fall assessment tools for elderly patients with diabetes. DESIGN A prospective cohort study. METHODS Between June and September 2019, a total of 1007 elderly patients with diabetes were enrolled from a tertiary specialist diabetes hospital in Tianjin and were prospectively followed up for 6 months to determine outcomes of accidental falls through telephone. Demographic and diseases related factors were collected at baseline. Incidence of falls was investigated, and a nomogram was developed based on logistic regression model. SPSS 21.0 and R 3.6.3 were used to analyse the data. The article was reported in accordance with STROBE guidelines. RESULTS Among 1007 elderly patients, 950 finished the follow-up. A total of 133 falls occurred in 93 patients during the follow-up period, with a fall rate of 9.79%. Diabetic peripheral neuropathy, walking aids, depression, fall history, fatigue and sex were independent predictors of accidental fall in diabetes elderly patients. The sensitivity and specificity of the predictive model were 73.12% and 52.63%, respectively, and a fall risk prediction nomogram was developed based on the regression model. CONCLUSIONS A nomogram including 6 easily available prediction factors (diabetic peripheral neuropathy, walking aids, depression, fall history within 1 year, fatigue, sex) was developed, and it can be used in safety management among Chinese elderly patients diagnosed with diabetes. RELEVANCE TO CLINICAL PRACTICE Nomogram can be used to identify diabetic elderly patients at high risk of accidental falls.
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Affiliation(s)
- Zhengnan Cheng
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaohui Li
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Hongmei Xu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Di Bao
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Chun Mu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Qiuling Xing
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
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Tang S, Liu M, Yang T, Ye C, Gong Y, Yao L, Xu Y, Bai Y. 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. BMC Geriatr 2022; 22:374. [PMID: 35484497 PMCID: PMC9047259 DOI: 10.1186/s12877-022-03055-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Falling is one of the main causes of death and morbidity in the elderly. This study aims to explore the association between elderly patients with chronic diseases and their health-related behaviors and falls in the elderly, and to provide clues for the prevention and intervention of injuries caused by falls in the elderly. METHODS Based on the basic demographic characteristics data, number of chronic diseases, health-related behaviors, and physical and mental health data of 5867 elderly people aged 60 and above in the 2018 CHARLS data, this paper used ordered logit regression to analyze the correlation between chronic diseases and their health-related behaviors and falls of Chinese elderly. On this basis, it also distinguishes whether there is care or not, explores whether the related factors of falls of elderly people will be different, and tests the intermediary effect of health status to further explore its mechanism. RESULTS The number of chronic diseases and health-related behaviors in the four dimensions of sleeptime, drinking, smoking, and activity are significantly correlated with falls in the elderly. Among them, health status plays a significant mediating role in the relationship of the number of chronic diseases and sleeptime and activity on the falls of the elderly. In addition, compared with the elderly without care, the risk of falls in the elderly in care is only related to the number of chronic diseases and sleeptime, while the elderly without care is related to the number of chronic diseases and multiple factors such as smoking, drinking and activity. CONCLUSION Falls are significantly associated with chronic disease and health-related behaviors, while risk or protective factors for falls vary according to whether older adults are cared for. Therefore, targeted interventions can be made for the factors that affect the fall of the elderly according to different situations.
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Affiliation(s)
- Shaoliang Tang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China.
| | - Meixian Liu
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tongling Yang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chaoyu Ye
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ying Gong
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ling Yao
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Xu
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Zhou Y, Hu Y, Luo J, Li Y, Liu H, Sun X, Zhou M. Association Between Sensory Loss and Falls Among Middle-Aged and Older Chinese Population: Cross-Sectional and Longitudinal Analyses. Front Med (Lausanne) 2022; 8:810159. [PMID: 35096898 PMCID: PMC8793905 DOI: 10.3389/fmed.2021.810159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/17/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction: Previous studies have suggested that sensory loss is linked to falls. However, most of these studies were cross-sectional designed, focused on single sensory loss, and were conducted in developed countries with mixed results. The current study aims to investigate the longitudinal relationship between hearing loss (HL), vision loss (VL) and dual sensory loss (DSL) with falls among middle-aged and older Chinese population over 7 years. Methods: The data was obtained from the China Health and Retirement Longitudinal Survey (CHARLS). In total, 7,623 Chinese older adults aged over 45 were included at baseline 2011 in this study. Self-reported falls and HL/VL/DSL were accepted. Other confounding variables included age, sex, BMI, educational level, marital status, various physical disorders and lifestyles. The impact of baseline sensory status on baseline prevalence of falls and incident falls over 7 years were assessed using logistic regression analyses. A logistic mixed model was used to assess the association between time-varying sensory loss with incident falls over 7 years after adjusted with multi-confounding factors. Results: Single and dual sensory loss groups had significantly higher prevalence of falls compared to no sensory loss (NSL) group (DSL: 22.4%, HL: 17.4%, VL: 15.7%, NSL: 12.3%). Baseline HL (OR: 1.503, 95% CI: 1.240-1.820), VL (OR: 1.330, 95% CI: 1.075-1.646) and DSL (OR: 2.061, 95% CI: 1.768-2.404) were significantly associated with prevalence of falls. For longitudinal observation over 7 years, baseline HL/DSL and persistence of all types of sensory loss were associated with incidence of falls. Time-varying HL (OR: 1.203, 95% CI: 1.070-1.354) and DSL (OR: 1.479, 95% CI: 1.343-1.629) were associated with incident falls after adjusted with multi-confounders, while VL was not. Conclusion: HL and DSL are significantly associated with both onset and increased incidence of falls over 7 year's observation in middle-aged and elderly Chinese population. Persistence or amelioration of sensory loss status could exert divergent influences on incidence of falls, which should be considered in the development of falls-prevention public health policies for aging population.
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Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Putuo People's Hospital, Tongji University, Shanghai, China
| | - Yanping Hu
- Shanghai Putuo Center for Disease Control and Prevention, Shanghai, China
| | - Jianfeng Luo
- School of Public Health, Fudan University, Shanghai, China
| | - Yinwen Li
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
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