Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Int J Clin Pract. 2021 Dec;75(12):e14999. doi: 10.1111/ijcp.14999. Epub 2021 Nov 5.
Older persons with diabetes are at an increased risk of falls leading to fractures, head injuries and disability.
To evaluate the potential relationship between falls and diabetes in older persons and identify differences in risk factors of falls among older persons with and without diabetes using the first wave dataset of the Malaysian Elders Longitudinal Research (MELoR) study.
Community dwelling adults aged 55 years were selected through stratified random sampling from three parliamentary constituencies in greater Kuala Lumpur. Baseline data was obtained through computer-assisted, home-based interviews. The presence of falls was established by enquiring about falls in the preceding 12 months. Diabetes was defined as self-reported, physician-diagnosed diabetes, diabetes medication use and an HbA1c of 6.3%.
Diabetes was present in 44.4% of the overall 1610 participants. The prevalence for fall among older diabetics was 25.6%. Recurrent falls (odds ratio (OR) 1.65; 95% confidence interval (CI) 1.06-2.57) was more common among diabetics. Following adjustment for potential confounders, osteoporosis (OR 2.58; 95% CI 1.31-5.08) and dizziness (OR 1.50; 95% CI 1.01-2.23) were independent risk factors for falls. Better instrumental activities of daily living scores were protective against falls (OR 0.75; 95% CI 0.58-0.97).
The presence of osteoporosis and dizziness was associated with an increased risk of falls among older diabetics. These findings will need to be confirmed in future prospective follow-up of this cohort.
患有糖尿病的老年人发生跌倒并导致骨折、头部受伤和残疾的风险增加。
评估老年人跌倒与糖尿病之间的潜在关系，并使用马来西亚老年人纵向研究（MELoR）研究的第一波数据集，确定有和没有糖尿病的老年人跌倒风险因素的差异。
通过分层随机抽样从吉隆坡三个选区选择年龄在 55 岁及以上的社区居住成年人。通过计算机辅助的家庭访谈获得基线数据。通过询问过去 12 个月内是否发生跌倒来确定是否发生跌倒。糖尿病的定义为自我报告、医生诊断的糖尿病、使用糖尿病药物和 HbA1c 为 6.3%。
在 1610 名参与者中，糖尿病的总体患病率为 44.4%。老年糖尿病患者跌倒的患病率为 25.6%。复发性跌倒（比值比（OR）1.65；95%置信区间（CI）1.06-2.57）在糖尿病患者中更为常见。在调整潜在混杂因素后，骨质疏松症（OR 2.58；95%CI 1.31-5.08）和头晕（OR 1.50；95%CI 1.01-2.23）是跌倒的独立危险因素。更好的工具性日常生活活动评分可预防跌倒（OR 0.75；95%CI 0.58-0.97）。
骨质疏松症和头晕的存在与老年糖尿病患者跌倒风险增加有关。这些发现需要在未来对该队列进行前瞻性随访中得到证实。
