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Frailty and prediction of recurrent falls over 10 years in a community cohort of 75-year-old women

Bartosch PS1,2, Kristensson J3, McGuigan FE1,2, Akesson KE4,5.

Aging Clin Exp Res. 2020 Jan 14. doi: 10.1007/s40520-019-01467-1. [Epub ahead of print]

Frailty captures the age-related declines in health leading to increased vulnerability, including falls which are commonplace in older women. The relationship between frailty and falls is complex, with one leading to the other in a vicious cycle.

This study addresses the gap in understanding how patterns of frailty and falls propensity interact, particularly in those who have not yet entered the falls-frailty cycle.

The Osteoporosis Risk Assessment cohort consists of 1044 community-dwelling women aged 75, with 10 years of follow-up. Investigations were performed and a frailty index constructed at baseline, 5 and 10 years. Falls were self-reported for each previous 12 months. Analysis was two-directional, firstly based on frailty status and second, based on falls status. Recurrent falls was the primary outcome.

Baseline frailty was a significant predictor of recurrent falls after 5 and 10 years [(OR 2.55 (1.62-3.99); 3.04 (1.63-5.67)]. Among women who had no history of falls at age 75, frailty was a stronger predictor of falls at 5 years [OR 3.06 (1.59-5.89)] than among women who had previously fallen.

Frailty is significantly associated with recurrent falls and most pronounced in those who are frail but have not yet fallen.

This suggests that frailty should be an integral part of falls-risk assessment to improve identification of those at risk of becoming fallers.