Falls by individuals with chronic obstructive pulmonary disease: A preliminary 12-month prospective cohort study


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Abstract

Background and objective:Despite evidence of an increased fall risk in people with chronic obstructive pulmonary disease (COPD), there is a paucity of prospective fall data in this population. This preliminary study aimed to prospectively examine the prevalence rate, incidence rate and associated risk factors for falls in a sample of community-dwelling people with COPD over 1 year.Methods:Forty-one participants with stable COPD (mean ± SD) aged 71 ± 8 years with a forced expiratory volume in 1 s of 45.1 ± 16.2% predicted were included. At baseline, participants' demographic, physical function and fall-related measures were documented. Falls were monitored for 12 months following initial assessments.Results:The prevalence of people having falls was 40% (95% CI: 24–56%); amongst these, 75% had frequent falls. The overall fall incidence rate was 1.17 falls/person-year. Risk factors associated with a higher fall incidence rate ratio (IRR) in COPD were: number of pack-years (IRR: 1.02; 95%CI: 1.00,1.04), comorbidities (IRR: 2.02; 95%CI: 1.42,3.06), number of medications (IRR: 1.15; 95%CI: 1.00,1.34), history of falls in the previous year (IRR: 1.89; 95%CI: 1.10,3.34), fear of falling (IRR: 1.08; 95% CI: 1.02,1.14) and higher score in a fall risk assessment questionnaire for older adults (IRR: 1.14; 95% CI: 1.05,1.25);P≤ 0.05. When adjusted for age, only pack-years (P= 0.01), number of comorbidities (P< 0.001) and history of falls (P= 0.03) were related to an increased fall incidence.Conclusions:These preliminary findings demonstrated the fall prevalence and incidence rate in community-dwelling people with stable COPD and identified prospective risk factors for an increased fall incidence, which suggest potential mitigation strategies.SUMMARY AT A GLANCEThis preliminary 12-month cohort study investigates the prevalence and incidence of falls in a sample of community-dwelling people with COPD. A high fall prevalence, incidence rate and a combination of patient and disease-related fall risk factors were identified in people with COPD.

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