Generalized and localized osteoarthritis and risk of fall among older adults: the role of chronic diseases and medications using real world data from a single center

A.M. Alenazi, A.S. Alhowimel, M.M. Alshehri, B.A. Alqahtani, N.A. Alhwoaimel, L.R. Waitman, P.M. Kluding

Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia. aqeelalenazi.pt@gmail.com

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• Geriatrics
• Rheumatology

OBJECTIVE: This study examined the prevalence of falls among older adults with generalized and localized osteoarthritis (OA) and identified the association between falls and both chronic diseases and medications.

PATIENTS AND METHODS: A retrospective design using the Healthcare Enterprise Repository for Ontological Narration (HERON) database was used. A cohort of 760 patients aged ≥65 years with at least two diagnosis codes for either localized or generalized OA were included. The extracted data included demographics (age, sex, and race), body mass index (BMI), fall history, comorbid health conditions (i.e., type 2 diabetes, hypertension, dyslipidemia, neuropathy, cardiovascular diseases, depression, anxiety, and sleep disorders), and medications [i.e., pain medication (opioids, non-opioids), antidiabetics (insulin or hypoglycemic), antihypertensives, antilipemic, and antidepressants].

RESULTS: The prevalence rates of falls and recurrent falls were 27.77% and 9.88%, respectively. Individuals with generalized OA had a higher prevalence of falls (33.8%) than those with localized OA (24.2%). Multivariable logistic regression analysis showed that individuals with OA who had hypertension [odds ratio (OR):1.86, 95% CI, (1.20, 2.89), p=0.006] and used antidepressants [OR: 1.72, 95% CI, (1.04, 2.84), p=0.035] were more likely to have a fall. Individuals with OA who had hypertension [OR: 2.69, 95% CI, (1.30, 5.60), p=0.008], neuropathy [OR: 4.95, 95% CI, (2.95, 11.68), p<0.001], and insulin [OR: 2.85, 95% CI, (1.12, 7.22), p=0.035] were more likely to have a recurrent fall (two or more falls).

CONCLUSIONS: Falls are common in individuals with generalized OA. Comorbid health conditions, including hypertension and neuropathy, need to be considered in the screening of the risk of fall. Fall risk needs to be considered when discussing medication prescriptions, especially antidepressants and insulin.

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