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Factors associated with falls in older women with breast cancer: the use of a brief geriatric screening tool in clinic

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Abstract

Purpose

Unintentional falls and breast cancer are common among older women, but the associations between them are understudied. We aimed to identify factors associated with falls in older women with breast cancer.

Methods

We retrospectively reviewed clinical records of older women with breast cancer at Duke Medical Center who had completed the Senior Adult Oncology Program geriatric assessment. Characteristics were compared between women had had at least one fall in the past year and those who did not. Pearson’s Chi-square tests and t tests were used for comparison of groups’ characteristics. Logistic regression determined factors associated with falling.

Results

We identified 425 women, age 76.2 years (range 65–89 years), at the time of the assessment. 118 (27.8%) women reported a fall in the prior year. Age, race, ethnicity, and time since diagnosis (all p > 0.05) were similar between groups. In univariate analyses, metastatic disease (p = 0.023) and history of endocrine therapy (p = 0.042) were more common among women who fell. Women who fell had lower systolic (p = 0.001), diastolic (p < 0.001) blood pressures, and SpO2 (p = 0.018). Women who had fallen had a higher Charlson Comorbidity Index (CCI: p = 0.033), and were more likely to report using a walking aide (p < 0.001), nutritional issues (p = 0.006), and depression symptoms (p = 0.038). In multivariate analysis, falling was associated with low DBP (OR 0.93; p = 0.0017), low SpO2 (OR 0.79; p = 0.0169), a higher CCI (OR 1.23; p = 0.0076), and depression symptoms (OR 1.61; p = 0.039).

Conclusions

Among older women with breast cancer, depressive symptoms, higher comorbidity level, and vital sign measurements were associated with having fallen.

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Acknowledgements

Special thanks to Julie Hughes.

Funding

This work was funded by the Breast Medical Oncology Program at Duke, and a donation from an anonymous donor for G Kimmick's research. Dr. Leah Zullig is supported by Veterans Affairs (VA) Health Services and Development (HSR&D) Career Development Awards (CDA 13-025).

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Authors and Affiliations

  1. Duke University Medical Center, Durham, NC, USA

    David B. Bartlett, Gloria Broadwater, Heidi K. White, Rebecca Shelby, Leah L. Zullig, Jessica Robertson, Harvey Jay Cohen & Gretchen Kimmick

  2. Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, Durham, NC, USA

    Leah L. Zullig

  3. Department of Population Health Sciences, Duke University, Durham, NC, USA

    Leah L. Zullig

  4. National Cancer Center Singapore, Singapore, Singapore

    Ravindran Kanesvaran

  5. Division of Medical Oncology, Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, 27701, USA

    David B. Bartlett

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  1. David B. Bartlett
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Correspondence to David B. Bartlett.

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Conflict of interest

Dr. Kimmick is consultant for Bohringer Ingleheim, Eisai, and Genomic Health, on the Speaker's bureau for Esai, and receives research funding to her program from Bionovo, PUMA, and Roche. Dr. Bartlett has no conflicts of interest pertinent to the submitted work. Miss Broadwater has no conflicts of interest pertinent to the submitted work. Dr. White has no conflicts of interest pertinent to the submitted work. Dr. Shelby has no conflicts of interest pertinent to the submitted work. Dr. Zullig has no conflicts of interest pertinent to the submitted work. Miss Robertson has no conflicts of interest pertinent to the submitted work. Dr. Kanesvaran has no conflicts of interest pertinent to the submitted work. Dr. Cohen has no conflicts of interest pertinent to the submitted work.

Ethical approval

This study was approved by the Duke Institutional Review Board (ID: Pro00044954). All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived because this study is a retrospective medical chart review, all data is de-identified, and that together has minimal level of risk.

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Bartlett, D.B., Broadwater, G., White, H.K. et al. Factors associated with falls in older women with breast cancer: the use of a brief geriatric screening tool in clinic. Breast Cancer Res Treat 184, 445–457 (2020). https://doi.org/10.1007/s10549-020-05862-5

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