PREVALENCE AND FEATURES OF GERIATRIC SYNDROMES TREATMENT IN OLD PATIENTS (CLINICAL AND EPIDEMIOLOGICAL STUDY)

2020 ◽  
pp. 331-338
Author(s):  
Е. Д. Голованова ◽  
Н. Е. Титова ◽  
Т. Е. Афанасенкова ◽  
И. А. Аргунова ◽  
Т. Н. Янковая ◽  
...  
Keyword(s):  
Geriatric Patients ◽  
Age Groups ◽  
Older Age ◽  
Age Dependence ◽  
Old Patients ◽  
Increased Risk ◽  
Planning Treatment ◽  
Risk Of Falls ◽  
Gender Characteristics ◽  
Outpatient Practice

Изучали распространенность хронических неинфекционных заболеваний (ХНИЗ) у пациентов пожилого и старческого возраста во взаимосвязи с синдромом старческой астении, распространенность саркопении в зависимости от гендерных особенностей и частоту встречаемости синдрома падений у пациентов старших возрастных групп с саркопенией. Анализировали особенности медикаментозной терапии в амбулаторной практике. Использовали метод комплексной гериатрической оценки у 528 пациентов, разделенных на три возрастные группы (65-74 года, 75-84 года, 85 лет и старше). Оказалось, что в структуре ХНИЗ у пациентов гериатрического профиля преобладают артериальная гипертензия, ИБС, а также их осложнения - ХСН и фибрилляция предсердий, частота встречаемости которых имеет выраженную возрастную зависимость и увеличивается у больных со старческой астенией. Для пациентов старших возрастных групп обоего пола характерно увеличение частоты встречаемости саркопении и связанного с ней повышенного риска синдрома падений, что необходимо учитывать при планировании лечебно-реабилитационных мер как в стационаре, так и при оказании первичной медикосоциальной помощи. We studied the prevalence of chronic non-communicable diseases (CND) in elderly and senile patients in conjunction with the syndrome of senile asthenia, the prevalence of sarcopenia depending on gender characteristics and the frequency of occurrence of the falls syndrome in patients with sarcopenia of older age groups. The features of drug therapy in outpatient practice were analyzed. The method of complex geriatric assessment was used in 528 patients divided into 3 age groups (65-74 years, 75-84 years, 85 years or more). It turned out that in the structure of CND in geriatric patients dominated: arterial hypertension, coronary heart disease, and their complications - chronic heart failure and atrial fi brillation their incidence has a pronounced age dependence and increases in patients with senile asthenia. Patients of older age groups of both sexes are characterized by an increase in the incidence of sarcopenia and the associated increased risk of falls syndrome, which must be taken into account when planning treatment and rehabilitation measures both in the hospital and when providing primary medical and social care.

HYPERTENSION IN ELDERLY:OUR CURRENT TRENDS

2021 ◽  
pp. 56-57
Author(s):  
Rohit Arora ◽  
D.K Sharma
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
The Elderly ◽  
Common Disease ◽  
Old Patients ◽  
Current Trends ◽  
Increased Risk ◽  
Individualized Approach ◽  
Risk Of Falls ◽  
Optimal Target

Hypertension is a common disease in the elderly associated with signicant morbidity and mortality. Due to the complexity of this population, the optimal target of blood pressure (BP) control is still controversial. In this article, we conduct a literature review of trials published in English in the last 10 years which were specically designed to study the efcacy and safety of various BP targets in patients who are 70 years or older. Using these criteria, we found that the benets in the positive studies were demonstrated even with a minimal BPcontrol (systolic BP[SBP] <150 mmHg) and continued to be reported for a SBP<120 mmHg. On the other hand, keeping SBP<140 mmHg seemed to be safely achieved in elderly patients. Although the safety of lowering SBP to <120 mmHg is debated, Systolic Blood Pressure Intervention Trial study has shown no increased risk of falls, fractures, or kidney failure in elderly patients with SBP lower than this threshold. While the recent guidelines recommended to keep BP <130/80 mmHg in the elderly, more individualized approach should be considered to achieve this goal in order to avoid undesirable complications. Furthermore, further studies are required to evaluate BPtarget in very old patients or those with multiple comorbidities.

scholarly journals Pulmonary tuberculosis among men over forty

1959 ◽  
Vol 57 (4) ◽  
pp. 367-385 ◽  
Author(s):  
Cecily M. Tinker
Keyword(s):  
Royal College ◽  
Age Groups ◽  
The Elderly ◽  
Older Age ◽  
Personal Hygiene ◽  
Tuberculous Infection ◽  
Elderly Men ◽  
Female Population ◽  
Heavy Smoking ◽  
Increased Risk

1. A review of the few studies so far made on the high mortality from tuberculosis among elderly men, and a consideration of the available statistics, indicate that urbanization is one of the principal factors responsible.2. In the present inquiry, which was confined to London, 445 newly diagnosed cases of tuberculosis in men over 40, together with the same number of paired controls, were studied by means of a questionnaire and of personal interview.3. It was found that the tuberculous patients differed significantly from the controls in the following characteristics; Scots, Irish, Welsh, or foreign nationality; single, widower or divorced; resident in common lodging houses or hostels; inadequate or special diet; history of gastrectomy; a winter cough; shortness of breath; insufficient sleep; and heavy drinking and smoking. On the other hand, overtime or night work, diabetes, rheumatoid arthritis, asthma, and mental illness were distributed fairly evenly in the two groups.4. Unfortunately no group of elderly women exists in this country living under the same sort of conditions as the elderly men studied here, so that it was impossible to determine how far the various factors considered were responsible for the high rate of late adult male tuberculosis. A study, however, of a population of established civil servants living under ordinary conditions revealed little difference between the observed rates of tuberculosis and those expected on the basis of national notification figures for men and women in the older age groups.5. It appears that a low standard of personal hygiene, associated especially with heavy smoking and drinking and residence in loading houses, predispose to the development of tuberculosis in the elderly male. Part of the evil effect of living in common lodging houses in particular may be due to the increased risk of exposure to tuberculous infection that it entails.6. It is tentatively concluded that the casual workers of an urbanized community are one of the principal reservoirs of tuberculous infection in large towns, and since there is no numerically comparable female population, this group, and its immediate male contacts, account in large measure for the difference between the male and female tuberculosis rates in the older age groups.This work was initiated during the tenure of a Prophit Scholarship of the Royal College of Physicians, and completed with the aid of a grant from the Medical Research Council.I am indebted to members of the Prophit Committee of the Royal College of Physicians for their support and encouragement, and most particularly to Dr G. S. Wilson, Director of the Public Health Laboratory Service, under whose guidance the work was carried out. Figures relating to the incidence of tuberculosis in the Civil Service are published by kind permission of Dr W. E. Chiesman, Treasury Medical Adviser, and Dr M. C. W. Long, Dr J. W. Parks, and Dr H. Stannus Stannus, whose departmental records were used to compute the figures.I am greatly indebted to the consultants and staff of the seventeen chest clinics who co-operated in the investigation, for their interest and help in tracing patients, and to the medical superintendents of numerous sanatoria and chest hospitals, and to the surgeons who permitted me to interview patients under their care as controls.I should like also to acknowledge the assistance received from the medical officers of health of the metropolitan boroughs who kept me informed of notifications from lodging houses in their areas, and supplied information about the accommodation.

Changes in the Dynamic Stability of Walking in Active Healthy Older Adults Independent of Changes in Walking Speed

2008 ◽  
Author(s):  
Hyun Gu Kang ◽  
Jonathan B. Dingwell
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Dynamic Stability ◽  
Walking Speed ◽  
Age Groups ◽  
Leg Strength ◽  
Age Related ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Walking Speeds

Older adults commonly walk slower, which many believe helps improve their walking stability. However, they remain at increased risk of falls. We investigated how differences in age and walking speed independently affect dynamic stability during walking, and how age-related changes in leg strength and ROM affected this relationship. Eighteen active healthy older and 17 younger adults walked on a treadmill for 5 minutes each at each of 5 speeds (80–120% of preferred). Local divergence exponents and maximum Floquet multipliers (FM) were calculated to quantify each subject’s responses to small inherent perturbations during walking. These older adults exhibited the same preferred walking speeds as the younger subjects (p = 0.860). However, these older adults still exhibited greater local divergence exponents (p&lt;0.0001) and higher maximum FM (p&lt;0.007) than young adults at all walking speeds. These older adults remained more unstable (p&lt;0.04) even after adjusting for declines in both strength and ROM. In both age groups, local divergence exponents decreased at slower speeds and increased at faster speeds (p&lt;0.0001). Maximum FM showed similar changes with speed (p&lt;0.02). The older adults in this study were healthy enough to walk at normal speeds. However, these adults were still more unstable than the young adults, independent of walking speed. This greater instability was not explained by loss of leg strength and ROM. Slower speeds led to decreased instability in both groups.

scholarly journals The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom

2017 ◽  
Vol 37 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Asmaa Al-Chidadi ◽  
Dorothea Nitsch ◽  
Andrew Davenport
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Sodium ◽  
Cox Regression ◽  
Strong Association ◽  
Age Groups ◽  
Older Age ◽  
Age Group ◽  
Younger Age ◽  
Increased Risk ◽  
The Uk

Background Studies in hemodialysis patients suggest that hyponatremia is associated with increased mortality. However, results from peritoneal dialysis (PD) patients are discordant. We wished to establish whether there was an association between serum sodium and mortality risk in PD patients. Methods We analyzed 3,108 PD patients enrolled at day 90 of renal replacement therapy (RRT) into the UK Renal Registry (UKRR) data base with available serum sodium measurements (in 3 groups: ≤ 137, 138 - 140, ≥ 141 mmol/L) who were then followed up until death or the censoring date (31 December 2012). Analysis used Cox-regression with adjustment for age, sex, year of starting RRT, primary renal disease, serum albumin, smoking, and comorbidities. Results Unadjusted mortality rates were 118.6/1,000 person-years (py), 83.4/1,000 py, and 83.5/1,000 py for the lowest, middle, and highest serum sodium tertiles, respectively. After adjustment for covariates, patients in the lowest serum sodium group had almost 50% increased risk of dying compared with those with the highest serum sodium (hazard ratio [HR] 1.49, confidence interval [CI]:1.28 - 1.74), with a graded association between serum sodium and mortality. The association of serum sodium with mortality varied by age (p interaction < 0.001), and whilst this association attenuated after adjustment for confounding variables in the older age groups (55 - 64, and > 65 years), it remained in the younger age group of 18 - 54 years (HR 2.24 [1.36 – 3.70] in the lowest compared with the highest sodium tertile). Conclusions Lower serum sodium concentrations at the start of RRT in PD patients are associated with increased risk of mortality. Whilst this association may well be due to confounding in the older age groups, the persistent strong association between hyponatremia and mortality in the younger age group after adjustment for the available confounders suggests that prospective studies are required to assess whether active intervention to maintain serum sodium changes outcomes.

scholarly journals Long-Term Relative Survival after Stroke: The Dijon Stroke Registry

2019 ◽  
Vol 54 (6) ◽  
pp. 498-505
Author(s):  
Gaëlle Romain ◽  
Anne-Sophie Mariet ◽  
Valérie Jooste ◽  
Gauthier Duloquin ◽  
Quentin Thomas ◽  
...  
Keyword(s):  
Sex Differences ◽  
Age Groups ◽  
Relative Survival ◽  
Older Age ◽  
Term Survival ◽  
Old Patients ◽  
Stroke Registry ◽  
Stroke Subtypes ◽  
Age And Sex

<b><i>Objective:</i></b> The aim of this study was to assess long-term survival after stroke and to compare survival profiles of patients according to stroke subtypes, age, and sex, using relative survival (RS) method. <b><i>Methods:</i></b> All patients with a first-ever stroke were prospectively recorded in the population-based Dijon Stroke Registry from 1987 to 2016. RS is the survival that would be observed if stroke was the only cause of death. Ten-year RS was estimated using a flexible parametric model of the cumulative excess mortality rate, which was obtained by matching the observed all-cause mortality in the stroke cohort to the expected mortality in the general population. A separate model was fitted for each stroke subtypes, first fitted for each age and sex separately, and then adjusted for age and sex. <b><i>Results:</i></b> In total, 5,259 patients (mean age 74.9 ± 14.3 years, 53% women) were recorded including 4,469 ischemic strokes (IS), 655 intracerebral hemorrhages (ICH), and 135 undetermined strokes. In IS patients, unadjusted RS was 82% at 1 year and decreased to 62% at 10 years. Adjusted RS showed a lower survival in older age groups (<i>p</i> &#x3c; 0.001), but no difference between men and women (<i>p</i> = 0.119). In ICH patients, unadjusted RS was 56 and 42% at 1 and 10 years, respectively, with a lower adjusted survival in older age groups (<i>p</i> &#x3c; 0.001), but no sex differences (<i>p</i> = 0.184). <b><i>Conclusion:</i></b> This study showed that RS after stroke is lower in older than in younger patients but without significant sex differences, and survival profiles differ according to stroke subtypes. Since RS allows a better estimation of stroke-related death than observed survival does, especially in old patients, such a method is adapted to provide reliable information when considering long-term outcome.

scholarly journals Target blood pressure levels in patients with arterial hypertension and frailty

2019 ◽  
Vol 16 (4) ◽  
pp. 52-60
Author(s):  
Olga D Ostroumova ◽  
Marina S Cherniaeva ◽  
Alexandr P Morozov
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Elderly People ◽  
Randomized Clinical Trials ◽  
Age Groups ◽  
Public Health Problem ◽  
Target Blood Pressure ◽  
Older Age ◽  
Final Decision ◽  
Increased Risk

Arterial hypertension (AH) is an important public health problem worldwide. The high prevalence of hypertension can partially be explained by an increase in blood pressure (BP) with age and a rapid increase in the elderly population (over 65 years old). Despite the effect of age on BP, evidence of target blood pressure values for its control in patients of older age groups with AH is limited, especially if they have frailty. There are data from a number of studies that reveal a relationship between lower BP levels and all-cause mortality in patients with AH in older age groups. In clinical practice, decisions regarding BP targets are especially difficult in elderly people with frailty who often do not meet the criteria for inclusion in randomized controlled trials and for this group of elderly people the clinical recommendations of leading communities do not give a specific answer about the target BP level. The evidence base regarding the target BP values in the treatment of AH in patients of older age groups with frailty presented in this review is not numerous, but its analysis suggests the advantages of higher BP numbers, with maximum systolic BP values of 165 mm Hg and diastolic BP of 90 mm Hg, while lower BP levels may be unsafe in terms of increasing the risk of adverse cardiovascular events and mortality from both cardiovascular causes and all causes. Polymorbidity in combination with polypharmacy and an increased risk of adverse events require a patient-oriented individual approach to the appointment of antihypertensive therapy. For a final decision on the management tactics of patients with AH and frailty, large, specially designed randomized clinical trials are needed.

Treatment patterns and survival outcomes of older patients with advanced pancreatic cancer (APC): A Canadian real-world evidence study.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 385-385
Author(s):  
Atul Batra ◽  
Ravi Ramjeesingh ◽  
Brandon M. Meyers ◽  
Michael M. Vickers ◽  
Rachel Anne Goodwin ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Real World ◽  
Geriatric Patients ◽  
Group Performance ◽  
Age Groups ◽  
Young Patients ◽  
Intensive Chemotherapy ◽  
Old Patients ◽  
Ecog Ps ◽  
Young Old

385 Background: We aimed to compare chemotherapy regimens used and overall survival (OS) among geriatric patients (≥ 75 years) with APC as compared to old (65-74 years) and young (< 65 years) patients with APC. Methods: In this retrospective population-based analysis, we identified patients with APC (defined as inoperable/metastatic disease) from 5 large provinces in Canada who were diagnosed from 2011 to 2016. Kaplan-Meier curves were plotted to derive OS and multivariable Cox regression models were constructed to determine the associations of different age groups on OS. Results: We included 636 patients diagnosed with APC of whom 258 (40.6%), 247 (38.8%) and 131 (20.6%) were young, old and geriatric. Approximately half (45.7%) of all patients were women. Eastern Cooperative Oncology Group performance status (ECOG PS) was known in 508 patients at diagnosis among whom 62.2% were 0-1 and 37.8% were 2+. ECOG PS was more likely to be 2+ in the geriatric group (46.8% vs 41.1% vs 31.3%; P = 0.017). Most patients (95.8%) had metastatic disease while the remaining patients had inoperable locally advanced disease. Within the study cohort, 38.7% received chemotherapy. Treatment rates differed based on age: 41.9% in young patients, 40.9% in old patients and 28.2% in geriatric patients (P = 0.02). Choice of first-line chemotherapy varied and included FOLFIRINOX (F) in 99 (40.2%), gemcitabine and nab-paclitaxel (GN) in 91 (37.0%) and gemcitabine (G) in 56 (22.8%). F, GN and G were administered in 27.0%, 32.4% and 40.5% of geriatric patients, 40.6%, 32.7% and 26.7% of old patients, and 44.4%, 42.6% and 13.0% of young patients, respectively (P = 0.007). After adjusting for baseline factors, both geriatric (odds ratio [OR], 0.70; 95% confidence interval [CI], 0.42-1.17; P = 0.175) and old patients were as likely to receive chemotherapy (OR, 1.04; 95% CI, 0.70-1.56; P = 0.815) as their young counterparts. The median OS was 7.1 (6.3-8.4), 6.7 (5.5-8.9) and 5.3 (4.3-6.8) months in young, old and geriatric patients, respectively. After adjusting for baseline variables, both geriatric (hazard ratio [HR], 1.25; 95% CI, 0.96-1.62; P = 0.101) and old patients (HR, 1.16; 95% CI, 0.94-1.42; P = 0.171) experienced similar OS as young patients. ECOG PS 2+ at presentation was associated with worse OS as was treatment with G. Conclusions: Overall treatment rates for APC are low in the real world. The poor OS in geriatric patients with APC is driven by poor PS and use of less intensive chemotherapy. Age alone should not be considered a contraindication for more intensive chemotherapy since treatment benefit is observed across all age groups. [Table: see text]

Biologic Features and Treatment Outcome of Secondary Acute Lymphoblastic Leukemia - Review of 101 Cases.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4345-4345
Author(s):  
Ranga Shivakumar ◽  
Wei Tan ◽  
Gregory Wilding ◽  
Eunice S. Wang ◽  
Meir Wetzler
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Age Groups ◽  
Primary Diagnosis ◽  
Initial Diagnosis ◽  
Older Age ◽  
Time Interval ◽  
Age Group ◽  
Complex Karyotype ◽  
Old Patients

Abstract Secondary acute lymphoblastic leukemia (sALL) is a rare disease and its biologic features are not well described. Data suggested that sALL occurs more frequently at older age. Since leukemia at older age in general is associated with worse outcome, we wanted to assess the biology and outcome of patients with sALL by age at time of primary diagnosis. We describe a cohort of 7 patients and found additional 94 cases in the literature on whom biological parameters were described. Patients were stratified (at least 5 patients per strata) according to their age at initial diagnosis (<18, 18–59, and ≥60 years of age), initial diagnosis [acute myeloid leukemia (AML), Hodgkin’s disease (HD), neuroblastoma, breast and prostate cancers], cytogenetic groups [diploid, t(9;22), 11q23 aberrations, complex karyotype], immunophenotypes (B vs. T), and Burkitt’s defined by either morphology and/or cytogenetic analysis demonstrating c-myc rearrangement. A total of 101 patients were evaluated; 29 were <18, 54 were 18–59 and 18 were ≥60 years old. The distribution of primary diagnoses was as expected: neuroblastoma was seen only in the <18 age group (P=0.003), HD was more common in the 18–59 age group (75% of all HD cases; P=0.084) while breast (P=0.003) and prostate (P=0.005) cancers were prevalent only in the >18 year old patients. The time interval to develop sALL was similar among the three age groups (3, 2.2 and 1.8 years, P=0.561). However, the time interval to develop sALL was longer for HD (5.5 years) and neuroblastoma (3.7 years) as compared to AML (1 year), breast (1.6 years) and prostate (1.98 years) cancers (overall P=0.0003). Further, the time interval to develop sALL was significantly longer for patients with complex karyotype (5.3 years) as compared to all other aberrations [11q23 − 1.78; t(9;22) − 1.9; diploid − 1.98 years; overall P=0.0497]. Disease characteristics at diagnosis were as follows: T cell immunophenotype was more common in the <18 age group (P=0.016) and the presence of 11q23, t(9;22), complex and normal karyotypes was equally distributed among the three age groups (P=0.2, 0.073, 0.635 and 0.271 individually). Complete remission was infrequent in the ≥60 age group (22.22%) compared to the other groups (73.9% for <18 and 67.7% for 18–59; P=0.025). Even though only patients <60 years old were transplanted (33.3% for <18 and 19.4% for 18–59; P=0.102), the overall survival was poor in all age groups [probability of survival at 1 year for <18=0.222, 18–59=0.226 and ≥60=0.3 (P=0.7941)]. Primary diagnoses, cytogenetic subgroups and immunophenotype did not affect outcome. In summary, the time interval to develop sALL is significantly longer for HD, neuroblastoma and complex karyotype. However, sALL is associated with very poor outcome regardless of age and any of the biologic features. Therefore, identification of prognostic factors to prevent the occurrence of sALL is needed.

scholarly journals Safety of parathyroidectomy in older vs. younger patients with primary hyperparathyroidism

2021 ◽  
Author(s):  
Marlena Mueller ◽  
Fahim Ebrahimi ◽  
Emanuel Christ ◽  
Christian Andreas Nebiker ◽  
Philipp Schuetz ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Older Patients ◽  
Large Population ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Population Based ◽  
Old Patients ◽  
Prolonged Length ◽  
Icu Admission ◽  
Increased Risk

Background: Primary hyperparathyroidism is a prevalent endocrinopathy for which surgery is the only curative option. Parathyroidectomy is primarily recommended in younger and symptomatic patients, while there are still concerns regarding surgical complications in older patients. We therefore assessed the association of age with surgical outcomes in patients undergoing parathyroidectomy in a large population in Switzerland. Methods: Population-based cohort study of adult patients with primary hyperparathyroidism undergoing parathyroidectomy in Switzerland between 2012 and 2018. The cohort was divided into four age groups (<50 years, 50-64 years, 65-74 years, ≥75 years). The primary outcome was a composite of in-hospital postoperative complications. Secondary outcomes were intensive care unit (ICU) admission, unplanned 30-day-readmission, and prolonged length of hospital stay. Results: We studied 2642 patients with a median (IQR) age of 62 (53 – 71) years. Overall, 111 patients had complications including surgical re-intervention, hypocalcemia, and vocal cord paresis. As compared to <50 year-old patients, older patients had no increased risk for in-hospital complications after surgery (50-64 years: OR 0.51 [95% CI 0.28 to 0.92]; 65-74 years: OR 0.72 [95% CI 0.39 to 1.33]; ≥75 years: OR 1.03 [95% CI 0.54 to 1.95]), respectively. There was also no association of age and rates of ICU-admission and unplanned 30-day-readmission, but oldest patients had longer hospital stays (OR 2.38 [95% CI 1.57 – 3.60]). Conclusion: ≥50 year-old patients undergoing parathyroidectomy had comparable risk of in-hospital complications as compared with younger ones. These data support parathyroidectomy in even older patients with primary hyperparathyroidism as performed in clinical routine.

scholarly journals 60 Obesity in Older Adults in the Epic Norfolk Study is Associated with Reduced 20-Year Falls Hospitalization

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Sheng Hui Kioh ◽  
Mat Sumaiyah ◽  
Phyo Myint ◽  
Maw Pin Tan
Keyword(s):  
Older Adults ◽  
Body Height ◽  
Age Groups ◽  
Age Group ◽  
Future Studies ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Using Data ◽  
The Relationship

Abstract Background One in three older adults fall each year leading to increased disability, hospitalizations and mortality. Recent studies suggested an increased risk of falls among obese individuals which may correlate with increased rates of falls hospitalizations. However, there is not much information supporting the hypothesis that obesity may influence the risk of falls related hospitalizations. Aims To prospectively investigate whether body mass index (BMI) is a predictor for falls hospitalization by age group in the population of the EPIC-Norfolk Study. Methods Body height and weight were measured at baseline and BMI calculated. Falls hospitalization status over 20 years’ follow-up was ascertained using data linkage with centralized NHS records. Participants were categorized into the four BMI groups: underweight (BMI &lt;18.5kg/m2 ), normal (18.5 ≤ BMI &lt; 25.0 kg/m2), overweight ( 25.0 ≤ BMI &lt; 30.0 kg/m2 ) and obese ( BMI ≥ 30.0kg/m2 ), and according to three age groups ( &lt; 55 years, 55-64 years, ≥ 65 years). Results Data from 25636 individuals, (54.7%) women and (45.3%) men, mean age 59.2 ± 9.3 years, were included. For individuals within the under 55-year age group at baseline, individuals who were overweight (HR = 1.25; 95% CI= 1.01-1.56) and obese (HR = 1.54; 95% CI= 1.17-1.81) were at higher risk of falls hospitalization compared with those with normal BMI. As for individuals aged ≥ 65 years at recruitment, individuals who were obese were less likely to be hospitalized after a fall (HR = 0.85; 95% CI= 0.74 – 0.97) compared to those with normal BMI. Conclusions The relationship between obesity and falls hospitalization over 20 years differed between those aged &lt;55years and 65years, with an increased risk observed for those &lt;55years and reduced risk in those 65years. The underlying rationale for this finding will need to be evaluated in future studies.

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