Background Falls are a common and serious concern facing older adults and the prevalence is increasing internationally. Falls lead to injury, hospitalisation, and substantial healthcare costs. Older people with diabetes may be at increased risk of falls, given the potential for polypharmacy and the development of microvascular complications. We aimed estimate prevalence of falls and examine the association between diabetes and a risk of falls in the older population using The Irish Longitudinal Study of Ageing (TILDA).
Methods Cross-sectional analysis was conducted on the first wave of TILDA data (2009–2011): a nationally representative sample of community-dwelling adults aged ≥50 years. Data were collected using a computer-assisted personal interview, self-completion survey and health assessment. Diabetes was based on self-report of doctor-diagnosis, the prevalence of falls in the previous year was also ascertained by self-report. The relationship between diabetes and falls risk was assessed using Pearson’s Chi-squared test. Multivariate poisson regression was used to examine the association between diabetes and falls, adjusted for age, sex, polypharmacy (≥5 different medications) and multimorbidity (≥3 chronic illnesses).
Results In the sample (n = 8175), the prevalence of falls in those with diabetes was 24% (n = 152 95% CI: 21–28%; P < 0.05) compared to 19% (n = 1431 95% CI: 18–20%; P < 0.05) in those without diabetes. Injuries due to falls were similar in both populations (36% diabetes: n = 152, 95% CI: 29–44%, P < 0.05; 36% no diabetes: n = 1431, 95% CI: 34–39%, P < 0.05).
When adjusted for age and gender, diabetes was significantly associated with an increased risk of falling (IRR: 1.23 95% CI: 1.04–1.45%; P < 0.05). Age and female gender were significantly associated with an increased risk of falls in older people (age: IRR: 1.02 95% CI: 1.01–1.03%; P < 0.05; sex: IRR: 1.12 95% CI: 1.01–1.23%).
Polypharmacy (IRR: 1.24 95% CI: 1.09–1.42%; P < 0.05) and multimorbidity (IRR: 1.30 95% CI: 1.11–1.54%; P < 0.05), were also both significantly associated in the age- and sex-adjusted model with falls. Upon their addition to the final model, there was a marked reduction in the association between diabetes and increased risk of falls (IRR: 1.02 95% CI: 0.85–1.22%; P = 0.834.)
Conclusion One-quarter of adults with diabetes experienced a fall in the preceding year. Our analysis showed an association between those who had fallen at least once in the previous year and diabetes, adjusted for age and gender. The relationship was not significant after adjustment for polypharmacy and multimorbidity. Given the potential for multimorbidity and polypharmacy in this group, people with diabetes may benefit from early recognition of their fall-risk and interventions to reduce risk.
- Diabetes Falls Elderly
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