Association between Multimorbidity and Risk of Falls and Fear of Falling among Older Adults: The Mediation Effect of Physical Function, Use of Sleeping Pills, and Pain Relievers.
J Am Med Dir Assoc
; 25(10): 105201, 2024 Aug 16.
Article
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| MEDLINE
| ID: mdl-39159914
ABSTRACT
OBJECTIVE:
Falls and fear of falling (FoF) are relevant contributors to disability and institutionalization among older adults. The aim was to examine the association between multimorbidity and falls/FoF among community-dwelling older adults, exploring the mediating effect of physical function and the use of sleeping pills and pain relievers. DESING Longitudinal analyses. SETTING ANDPARTICIPANTS:
A total of 1824 adults aged ≥65 years from the Seniors-ENRICA II cohort (Spain).METHODS:
Multimorbidity was defined as having ≥2 diseases from a predefined list of 13 chronic conditions extracted from clinical records. Falls were self-reported and FoF was estimated using the Short Falls Efficacy Scale International. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between multimorbidity/duration of multimorbidity and incident falls/FoF using logistic regression models. The mediating effects of physical function, the use of sleeping pills, and pain relievers were explored using the Karlson Holm Breen method.RESULTS:
Multimorbidity was associated with a higher risk of falls (OR, 1.44; 95% CI, 1.14-1.82) and FoF (OR, 1.88; 95% CI, 1.48-2.39). Positive dose-response associations were found between the duration of multimorbidity and the risk of falls (P-trend = .003) and FoF (P-trend = .001). Physical function mediated 5.67% and 5.25% of these associations, respectively, and the use of sleeping pills explained a larger proportion of the associations (9.27% and 11.61%). Last, the mediation effect of pain relievers on the association between multimorbidity and falls was 3.05% and 9.31% in the multimorbidity-FoF association. CONCLUSIONS AND IMPLICATIONS Multimorbidity was associated with a higher risk of falls/FoF among Spanish community-dwelling older adults. Use of sleeping pills was a relevant mediator, suggesting that interventions on sleep problems have the potential to reduce the burden of falls/FoF and their consequences among older adults with multimorbidity.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
J Am Med Dir Assoc
Asunto de la revista:
HISTORIA DA MEDICINA
/
MEDICINA
Año:
2024
Tipo del documento:
Article
País de afiliación:
España
Pais de publicación:
Estados Unidos