Nicola Veronese1, Giacomo Siri2, Alberto Cella2, Stefania Maggi3, Ekaterini Zigoura2, Matteo Puntoni2, Lee Smith4, Clarissa Musacchio2, Antonella Barone2, Carlo Sabbà5, Francesco Vallone2, Alberto Pilotto6. 1. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance & High Specialization Hospital, Genoa, Italy; Azienda ULSS 3 Serenissima, Primary Care Department, District 3, Venice, Italy. 2. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance & High Specialization Hospital, Genoa, Italy. 3. Azienda ULSS 3 Serenissima, Primary Care Department, District 3, Venice, Italy. 4. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK. 5. Department of Interdisciplinary Medicine, University of Bari, Bari, Italy. 6. Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance & High Specialization Hospital, Genoa, Italy; Department of Interdisciplinary Medicine, University of Bari, Bari, Italy. Electronic address: alberto.pilotto@galliera.it.
Abstract
OBJECTIVES: Falls are associated with several negative outcomes. Early identification of those who are at risk of falling is of importance in geriatrics, and comprehensive geriatric assessment (CGA) seems to be promising in this regard. Therefore, the present study investigated whether the multidimensional prognostic index (MPI), based on a standard CGA, is associated with falls in the Osteoarthritis Initiative (OAI). DESIGN: Longitudinal, 8 years of follow-up. SETTING AND PARTICIPANTS: Community-dwelling older people (≥65 years of age) with knee osteoarthritis or at high risk for this condition. METHODS: A standardized CGA including information on functional, nutritional, mood, comorbidities, medications, quality of life, and cohabitation status was used to calculate a modified version of the MPI, categorized as MPI-1 (low), MPI-2 (moderate), and MPI-3 (high risk). Falls were self-reported and recurrent fallers were defined as ≥2 in the previous year. Logistic regression was carried out and results are reported as odds ratio (ORs) with their 95% confidence intervals (CIs). RESULTS: The final sample consisted of 885 older adults (mean age 71.3 years, female = 54.6%). Recurrent fallers showed a significant higher MPI than their counterparts (0.46 ± 0.17 vs 0.38 ± 0.16; P < .001). Compared with those in MPI-1 category, participants in MPI-2 (OR 2.13; 95% CI 1.53‒2.94; P < .001) and in MPI-3 (OR 5.98; 95% CI 3.29-10.86; P < .001) reported a significant higher risk of recurrent falls over the 8-years of follow-up. Similar results were evident when using an increase in 0.1 points in the MPI or risk of falls after 1 year. CONCLUSIONS AND IMPLICATIONS: Higher MPI values at baseline were associated with an increased risk of recurrent falls, suggesting the importance of CGA in predicting falls in older people.
OBJECTIVES: Falls are associated with several negative outcomes. Early identification of those who are at risk of falling is of importance in geriatrics, and comprehensive geriatric assessment (CGA) seems to be promising in this regard. Therefore, the present study investigated whether the multidimensional prognostic index (MPI), based on a standard CGA, is associated with falls in the Osteoarthritis Initiative (OAI). DESIGN: Longitudinal, 8 years of follow-up. SETTING AND PARTICIPANTS: Community-dwelling older people (≥65 years of age) with knee osteoarthritis or at high risk for this condition. METHODS: A standardized CGA including information on functional, nutritional, mood, comorbidities, medications, quality of life, and cohabitation status was used to calculate a modified version of the MPI, categorized as MPI-1 (low), MPI-2 (moderate), and MPI-3 (high risk). Falls were self-reported and recurrent fallers were defined as ≥2 in the previous year. Logistic regression was carried out and results are reported as odds ratio (ORs) with their 95% confidence intervals (CIs). RESULTS: The final sample consisted of 885 older adults (mean age 71.3 years, female = 54.6%). Recurrent fallers showed a significant higher MPI than their counterparts (0.46 ± 0.17 vs 0.38 ± 0.16; P < .001). Compared with those in MPI-1 category, participants in MPI-2 (OR 2.13; 95% CI 1.53‒2.94; P < .001) and in MPI-3 (OR 5.98; 95% CI 3.29-10.86; P < .001) reported a significant higher risk of recurrent falls over the 8-years of follow-up. Similar results were evident when using an increase in 0.1 points in the MPI or risk of falls after 1 year. CONCLUSIONS AND IMPLICATIONS: Higher MPI values at baseline were associated with an increased risk of recurrent falls, suggesting the importance of CGA in predicting falls in older people.
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