open access
Functional status as a predictor of the incidence of falls in 10-year follow-up: results from the RAC-OST-POL study
- Department and Clinic of Internal Diseases, Diabetology, and Nephrology, Metabolic Bone Diseases Unit, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
- Department of Paediatrics, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
open access
Abstract
Introduction: The aim of this prospective study was to establish the influence of baseline functional status on the incidence of falls.
Material and methods: The study was performed in an epidemiological sample of postmenopausal women from the RAC-OST-POL study. At baseline there were 978 postmenopausal women with a mean age of 65.9 ± 7.6 years, and at the end of 10-year follow-up 640 patients with a mean age of 65.04 ± 6.95 years remained in observation. Functional status was established at baseline using a stand up and go test (SAG) and the Lawton Instrumental Activities of Daily Living (IADL) scale. Afterwards, data on fall incidence were updated annually using phone interviews.
Results: In a 10-year period of observation, in 384 (60%) women at least one fall occurred. At baseline, 90% of subjects achieved maximal value in the IADL scale (24 points). Although the difference between mean IADL score in those who fell and did not fall was noticeable (23.50 ± 1.68 vs. 23.65 ± 1.47, respectively), the category of any IADL score below 24 points was significantly more frequent in women with falls (71.9% vs. 28.1%; chi-square 4.2, p < 0.05). The SAG score in the subgroup with falls was (10.75 ± 3.39) and did not differ in comparison to subgroup without falls (10.27 ± 2.72).
Conclusion: The baseline result of the IADL scale but not that of the SAG test are related to the incidence of falls in a 10-year prospective observation. Adequate correction of functional status may benefit patients and reduce the fall rate.
Abstract
Introduction: The aim of this prospective study was to establish the influence of baseline functional status on the incidence of falls.
Material and methods: The study was performed in an epidemiological sample of postmenopausal women from the RAC-OST-POL study. At baseline there were 978 postmenopausal women with a mean age of 65.9 ± 7.6 years, and at the end of 10-year follow-up 640 patients with a mean age of 65.04 ± 6.95 years remained in observation. Functional status was established at baseline using a stand up and go test (SAG) and the Lawton Instrumental Activities of Daily Living (IADL) scale. Afterwards, data on fall incidence were updated annually using phone interviews.
Results: In a 10-year period of observation, in 384 (60%) women at least one fall occurred. At baseline, 90% of subjects achieved maximal value in the IADL scale (24 points). Although the difference between mean IADL score in those who fell and did not fall was noticeable (23.50 ± 1.68 vs. 23.65 ± 1.47, respectively), the category of any IADL score below 24 points was significantly more frequent in women with falls (71.9% vs. 28.1%; chi-square 4.2, p < 0.05). The SAG score in the subgroup with falls was (10.75 ± 3.39) and did not differ in comparison to subgroup without falls (10.27 ± 2.72).
Conclusion: The baseline result of the IADL scale but not that of the SAG test are related to the incidence of falls in a 10-year prospective observation. Adequate correction of functional status may benefit patients and reduce the fall rate.
Keywords
female; functional status; fall incidence
Title
Functional status as a predictor of the incidence of falls in 10-year follow-up: results from the RAC-OST-POL study
Journal
Issue
Article type
Original paper
Pages
404-407
Published online
2023-07-18
Page views
679
Article views/downloads
222
DOI
Pubmed
Bibliographic record
Endokrynol Pol 2023;74(4):404-407.
Keywords
female
functional status
fall incidence
Authors
Wojciech Pluskiewicz
Piotr Adamczyk
Bogna Drozdzowska
- Rockwood K. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005; 173(5): 489–495.
- Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986; 34(2): 119–126.
- Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39: 142–148.
- Lawton MP, Brody EM. Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. Gerontologist. 1969; 9(3 Part 1): 179–186.
- Pluskiewicz W, Adamczyk P, Czekajło A, et al. Falls in RAC-OST-POL Study: epidemiological study in postmenopausal women aged over 55 years. Endokrynol Pol. 2016; 67(2): 185–189.
- Drozdzowska B, Wiktor K, Pluskiewicz W. Functional status and prevalence of falls and fractures in population-based sample of postmenopausal women from the RAC-OST-POL Study. Int J Clin Pract. 2013; 67(7): 673–681.
- Nguyen ND, Frost SA, Center JR, et al. Development of a nomogram for individualizing hip fracture risk in men and women. Osteoporos Int. 2007; 18(8): 1109–1117.
- Nguyen ND, Frost SA, Center JR, et al. Development of prognostic nomograms for individualizing 5-year and 10-year fracture risks. Osteoporos Int. 2008; 19(10): 1431–1444.
- Adamczyk P, Werner A, Bach M, et al. Risk Factors for Fractures Identified in the Algorithm Developed in 5-Year Follow-Up of Postmenopausal Women From RAC-OST-POL Study. J Clin Densitom. 2018; 21(2): 213–219.
- Zagórski P, Tabor E, Martela-Tomaszek K, et al. Five-year fracture risk assessment in postmenopausal women, using both the POL-RISK calculator and the Garvan nomogram: the Silesia Osteo Active Study. Arch Osteoporos. 2021; 16(1): 32.
- Pluskiewicz W, Adamczyk P, Werner A, et al. Epidemiological data on osteoporosis in women from the RAC-OST-POL study. J Clin Densitom. 2012; 15(3): 308–314.
- Dorfman JD, Wyman A, FitzGerald G, et al. Risks factors for significant injury after geriatric falls. Int J Aging Res. 2019; 2(1).
- Batko-Szwaczka A, Wilczyński K, Hornik B, et al. Predicting Adverse Outcomes in Healthy Aging Community-Dwelling Early-Old Adults with the Timed Up and Go Test. Clin Interv Aging. 2020; 15: 1263–1270.
- Vergara I, Vrotsou K, Orive M, et al. Factors related to functional prognosis in elderly patients after accidental hip fractures: a prospective cohort study. BMC Geriatr. 2014; 14: 124.
- Northridge ME, Nevitt MC, Kelsey JL, et al. Home hazards and falls in the elderly: the role of health and functional status. Am J Public Health. 1995; 85(4): 509–515.
- Mangani I, Cesari M, Russo A, et al. Physical function, physical activity and recent falls. Results from the "Invecchiamento e Longevità nel Sirente (ilSIRENTE)" Study. Aging Clin Exp Res. 2008; 20(3): 234–241.
- Cai Y, Schrack JA, Wang H, et al. Visual Impairment and Objectively Measured Physical Activity in Middle-Aged and Older Adults. J Gerontol A Biol Sci Med Sci. 2021; 76(12): 2194–2203.
- Patino CM, McKean-Cowdin R, Azen SP, et al. Los Angeles Latino Eye Study Group. Central and peripheral visual impairment and the risk of falls and falls with injury. Ophthalmology. 2010; 117(2): 199–206.
- Fukuoka H, Nagaya M, Toba K. The occurrence of visual and cognitive impairment, and eye diseases in the super-elderly in Japan: a cross-sectional single-center study. BMC Res Notes. 2015; 8: 619.
- Niihata K, Fukuma S, Hiratsuka Y, et al. Association between vision-specific quality of life and falls in community-dwelling older adults: LOHAS. PLoS One. 2018; 13(4): e0195806.
- Steinman BA, Pynoos J, Nguyen AQD. Fall risk in older adults: roles of self-rated vision, home modifications, and limb function. J Aging Health. 2009; 21(5): 655–676.
- Kupisz-Urbańska M, Stuss M, Kuryłowicz A, et al. Fracture risk in obesity: a narrative review. Endokrynol Pol. 2022; 73(5): 885–892.
- Kong QX, Ruan Q, Fan C, et al. Evaluation of the risk of fracture in type 2 diabetes mellitus patients with incretins: an updated meta-analysis. Endokrynol Pol. 2021; 72(4): 319–328.