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Predicting falls in elderly patients with chronic pain and other chronic conditions

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Abstract

Background

The aim was to identify fall predictors in elderly suffering from chronic pain (CP) and to test their applicability among patients with other chronic conditions.

Methods

1,379 non-institutionalized patients aged 65 years and older who were suffering from CP (S.AGE CP sub-cohort) were monitored every 6 months for 1 year. Socio-demographic, clinical and pain data and medication use were assessed at baseline for the association with falls in the following year. Falls were assessed retrospectively at each study visit. Logistic regression analyses were performed to identify fall predictors. The derived model was applied to two additional S.AGE sub-cohorts: atrial fibrillation (AF) (n = 1,072) and type-2 diabetes mellitus (T2DM) (n = 983).

Results

Four factors predicted falls in the CP sub-cohort: fall history (OR: 4.03, 95 % CI 2.79–5.82), dependency in daily activities (OR: 1.81, 95 % CI 1.27–2.59), age ≥75 (OR: 1.53, 95 % CI 1.04–2.25) and living alone (OR: 1.73, 95 % CI 1.24–2.41) (Area Under the Curve: AUC = 0.71, 95 % CI 0.67–0.75). These factors were relevant in AF (AUC = 0.71, 95 % CI 0.66–0.75) and T2DM (AUC = 0.67, 95 % CI 0.59–0.73) sub-cohorts. Fall predicted probability in CP, AF and T2DM sub-cohorts increased from 7, 7 and 6 % in patients with no risk factors to 59, 66 and 45 % respectively, in those with the four predictors. Fall history was the strongest predictor in the three sub-cohorts.

Conclusion

Fall history, dependency in daily activities, age ≥75 and living alone are independent fall predictors in CP, AF and T2DM patients.

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Conflict of interest

Lazkani A: no conflict of interest. Becquemont L: received consulting fees from Sanofi-Aventis, Pfizer and Servier and lecture fees from Genzyme, GlaxoSmithKline, Bristol-Myers Squibb and Merck Sharp & Dohme. Close family member working at Sanofi France. Delespierre T: no conflict of interest. Benattar-Zibi L: no conflict of interest. Bauduceau B: received consulting fees from Sanofi-Aventis, Bristol-Myers Squibb, Merck Sharp & Dohme, Roche and Novo Nordisk. Bertin P: received consulting fees from Sanofi-Aventis, Pfizer, Ethypharm and Reckitt Benckiser and speaking fees from Genevrier, Roche, Bristol-Myers Squibb and Merck Sharp & Dohme. Berrut G: received fees from Sanofi, Lundbeck, Eisai, Novartis, MSD, Amgen, Boehringer Ingelheim and Bayer. Corruble E: received consulting fees from Servier, Lundbeck, Sanofi-Aventis, Bristol Myers Squibb and Eisai. Danchin N: received consulting or speaking fees from AstraZeneca, BMS, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, GSK, MSD Schering-Plough, Novartis, Novo Nordisk, Pierre Fabre, Pfizer, Roche, Sanofi-Aventis, Servier, Takeda and The Medicines Company. Derumeaux G: received consulting or speaking fees from Actelion, Boehringer Ingelheim, Pfizer, Sanofi-Aventis and Servier. Research grant from Actelion and AstraZeneca. Doucet J: received speaking fees from Novo Nordisk, consulting fees from Sanofi-Aventis, Novo Nordisk and Merck Serono and has a research partnership with Lilly. Falissard B: received consulting fees from Sanofi-Aventis, Servier, Roche, AstraZeneca, Grünenthal, Lilly, HRA, Boehringer Ingelheim, Bayer, Novartis, Genzyme, Stallergenes, Daiichi, Otsuka and BMS. Forette F: received speaking and consulting fees from AstraZeneca, Bayer, BMS, Esaï, Exonhit, Fabre, Ipsen, Janssen-Cilag, Lilly, Lundbeck, Novartis, MSD, Merz, Pfizer, Roche, Sanofi-Aventis, Servier, Schwartz Pharma, Specia, Warner–Lambert and Wyeth. Hanon O: received speaking and consulting fees from AstraZeneca, Bayer, BMS, Boehringer, Esaï, Exonhit, Janssen-Cilag, Lundbeck, Novartis, Pfizer, Sanofi-Aventis and Servier. Pasquier F: Investigator for Eisai, Exonhit, Novartis, Ipsen, Medivation, Pfizer, Bayer, Noscira, Sanofi, Roche and GE Healthcare. Received consulting fees from Lilly, Bayer, Janssen and Sanofi. Pinget M: received speaking and consulting fees from Asdia, AstraZeneca, BMS, Medtronic, MSD, Novo Nordisk, Novartis, Roche Diagnostic and Ypsomed. Ourabah R: no conflict of interest. Piedvache C: no conflict of interest.

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Authors and Affiliations

  1. Pharmacology Department, Paris-Sud Faculty of Medicine, AP-HP, Bicêtre Hospital, Paris-Sud University, 63, rue Gabriel Péri, 94276, Le Kremlin-Bicêtre, France

    Aida Lazkani, Tiba Delespierre, Celine Piedvache & Laurent Becquemont

  2. Endocrinology Department, Bégin Hospital, Saint-Mandé, France

    Bernard Bauduceau

  3. ORPEA/CLINEA, Puteaux, France

    Linda Benattar-Zibi

  4. Rheumatology Department, Limoges University Hospital, Limoges, France

    Philippe Bertin

  5. Clinical Gerontology, Nantes University Hospital, Nantes, France

    Gilles Berrut

  6. Paris-Sud Faculty of Medicine, Psychiatry Department, Bicêtre University Hospital, AP-HP, INSERM U 669, Paris-Sud University, Le Kremlin-Bicêtre, France

    Emmanuelle Corruble

  7. HEGP, Coronary Diseases, Paris, France

    Nicolas Danchin

  8. Cardiovascular Functional Exploration, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France

    Geneviève Derumeaux

  9. Internal Medicine, Geriatrics and Therapeutics, Saint Julien University Hospital, Rouen University, Rouen, France

    Jean Doucet

  10. Paris-Sud Faculty of Medicine, Biostatistics Department, AP-HP, Paul Brousse Hospital, INSERM U 669, Paris-Sud University, Le Kremlin-Bicêtre, France

    Bruno Falissard

  11. National Gerontology Foundation, Paris Descartes University, Paris, France

    Francoise Forette

  12. AP-HP, Broca Hospital, Geriatrics Department, Paris Descartes University, EA 4468, Paris, France

    Olivier Hanon

  13. Lille University Hospital, Lille Nord de France University, UDSL, EA 1046, Lille, France

    Florence Pasquier

  14. Endocrinology, Diabetes and Nutrition-Related Diseases (NUDE Unit), Strasbourg University Hospital, and the European Centre for the Study of Diabetes (CeeD), Strasbourg University, Strasbourg, France

    Michel Pinget

  15. General Practice Department, Paris-Sud Faculty of Medicine, Paris-Sud University, Le Kremlin-Bicêtre, France

    Rissane Ourabah

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  1. Aida Lazkani
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  2. Tiba Delespierre
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  3. Bernard Bauduceau
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  4. Linda Benattar-Zibi
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  7. Emmanuelle Corruble
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  8. Nicolas Danchin
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  9. Geneviève Derumeaux
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  10. Jean Doucet
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  11. Bruno Falissard
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  12. Francoise Forette
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  13. Olivier Hanon
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  14. Florence Pasquier
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  15. Michel Pinget
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  16. Rissane Ourabah
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  17. Celine Piedvache
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  18. Laurent Becquemont
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Correspondence to Aida Lazkani.

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Lazkani, A., Delespierre, T., Bauduceau, B. et al. Predicting falls in elderly patients with chronic pain and other chronic conditions. Aging Clin Exp Res 27, 653–661 (2015). https://doi.org/10.1007/s40520-015-0319-2

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  • DOI: https://doi.org/10.1007/s40520-015-0319-2

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