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Baseline health-related quality of life predicts falls: a secondary analysis of a randomized controlled trial

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Abstract

Purpose

Among older adults, health-related quality of life (HRQoL) and falls are associated. Generic patient-reported outcomes measures (PROMs) assess individual’s HRQoL. The role for PROMs, a potential tool for predicting subsequent falls, remains under-explored. Our primary aim was to determine whether a baseline PROMs assessment of HRQoL may be a useful tool for predicting future falls.

Methods

A secondary analysis of a 12-month randomized clinical trial (RCT) of a home-based exercise program among 344 adults (67% female), aged ≥ 70 years, with ≥ 1 falls in the prior year who were randomized (1:1) to either a home-based exercise program (n = 172) or usual care (n = 172). A negative binomial regression model with total falls count as the dependent variable evaluated the main effect of the independent variable–baseline HRQoL (measured by the Short-Form-6D)–controlling for total exposure time and experiment group (i.e., exercise or usual care) for the total sample. For the usual care group alone, the model controlled for total exposure time.

Results

For the total sample, the rate of subsequent total falls was significantly predicted by baseline HRQoL (IRR = 0.044; 95% CI [0.005–0.037]; p = .004). For the usual care group, findings were confirmed with wider confidence intervals and the rate of prospective total falls was significantly predicted by baseline HRQoL (IRR = 0.025; 95% CI [0.001–0.909]; p = .044).

Conclusion

These findings suggest the ShortForm-6D should be considered as part of falls prevention screening strategies within a Falls Prevention Clinic setting.

Trial Registrations ClinicalTrials.gov Protocol Registration System. Identifier: NCT01029171; URL: https://clinicaltrials.gov/ct2/show/NCT01029171. Identifier: NCT00323596; URL: https://clinicaltrials.gov/ct2/show/NCT00323596.

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Acknowledgements

We thank the participants for their time and dedication.

Funding

This work was supported by the Canadian Institutes for Health Research (MOP-110954 and MAT-92025). TLA is a Canada Research Chair (Tier 1) in Healthy Aging. JCD is a Michael Smith Foundation for Health Research Career Scholar and a Canada Research Chair (Tier 2) in Applied Health Economics. The Canadian Institutes for Health Research had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Applied Health Economic Laboratory, Faculty of Management, University of British Columbia, 1137 Alumni Avenue, Kelowna, BC, V1V 1V7, Canada

    Jennifer C. Davis

  2. Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada

    Jennifer C. Davis, Chun Liang Hsu, Cheyenne Ghag, Samantha Y. Starkey, Patrizio Jacova & Teresa Liu-Ambrose

  3. Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada

    Jennifer C. Davis, Chun Liang Hsu, Cheyenne Ghag, Samantha Y. Starkey, Patrizio Jacova & Teresa Liu-Ambrose

  4. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada

    Jennifer C. Davis, Chun Liang Hsu, Cheyenne Ghag, Samantha Y. Starkey, Patrizio Jacova & Teresa Liu-Ambrose

  5. Social & Economic Change Laboratory, Faculty of Management, University of British Columbia, Kelowna, BC, Canada

    Jennifer C. Davis

  6. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Samantha Y. Starkey & Larry Dian

  7. Department of Medicine, Division of Geriatric Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Naaz Parmar & Kenneth Madden

  8. Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA

    Chun Liang Hsu

  9. Harvard Medical School, Harvard University, Boston, MA, USA

    Chun Liang Hsu

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  1. Jennifer C. Davis
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Contributions

TLA: had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. TLA, JCD and LD: Study Concept and Design. TLA, LD, SYS, PJ, CLH, LD, NP and KM: Acquisition of Data. JCD, TLA and SYS: Analysis and Interpretation of Data. JCD, SYS and TLA: Drafting of the Manuscript. JCD, SYS, TLA, CG, PJ, LD, NP and KM: Critical Revision of the Manuscript for Important Intellectual Content. JCD and TLA: Statistical Analysis. JCD and TLA: Obtained Funding and TLA, JCD, CLH, PJ, LD, NP and KM: Administrative, Technical, or Material Support. TLA and JCD: Study Supervision.

Corresponding author

Correspondence to Jennifer C. Davis.

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Conflict of interest

Liu-Ambrose, Davis and Dian direct the Falls Prevention Clinic.

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This study received ethical approval from the University of British Columbia Research Ethics Boards.

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All participants provided written informed consent.

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Davis, J.C., Hsu, C.L., Ghag, C. et al. Baseline health-related quality of life predicts falls: a secondary analysis of a randomized controlled trial. Qual Life Res 31, 3211–3220 (2022). https://doi.org/10.1007/s11136-022-03175-2

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