Complications such as sarcopenia, frailty, and decreased intrinsic capacity are associated with falls in patients with stable schizophrenia.

OBJECTIVE

Falls have significant health consequences and are a common complication in psychiatric patients. Studies have shown associations of falls with sarcopenia, frailty, and decreased intrinsic capacity (IC). However, these relationships have not been investigated in schizophrenia patients. Here, we aim to the assessment of the role of sarcopenia, frailty, and decreased IC as predictors of falls in patients with stable schizophrenia.

MEASUREMENTS

Design: Retrospective cohort study.

SETTING AND PARTICIPANTS

The study included inpatients diagnosed with schizophrenia from two mental health centers in Western China. The inclusion criteria were inpatients aged 50 years and over as well as those on regular neuroleptic medication. Basic information was obtained through face-to-face interviews with the patients. Sarcopenia was diagnosed following the diagnostic criteria, defined by the Asian Working Group for Sarcopenia (AWGS) 2019. Frailty was measured by the FRAIL scale, while IC was evaluated through assessment of five characteristics: cognition, psychological, sensory function, vitality and locomotion. The outcome indicator was the number of falls in the past year, obtained by consulting the medical records and interrogating the patients and medical staff. The correlation between sarcopenia, frailty, IC and falls was analyzed by logistic regression analysis.

RESULTS

339 patients diagnosed with stable schizophrenia were recruited in the study, with a mean age of 65 years among who 232 (68.44 %) were males. 55 (16.22 %) of them reported falls in the past year. Patients diagnosed with sarcopenia and frailty were 180 (53.10 %) and 47 (13.86 %), respectively. 321 were diagnosed with IC decline, of which 130 (40.50 %), 73 (22.74 %), 68 (21.18 %), 44 (13.71 %) and 6 (1.87 %) were impaired in one, two, three, four, and five dimensions, respectively. Patients with sarcopenia and frailty had a higher incidence of falls than those without (sarcopenia: 21.67 % vs 10.06 %, P = 0.004; frailty: 31.91 % vs 13.7 %, P = 0.002). The IC score of the fall group was significantly higher than that in the non-fall group (P = 0.001). After adjustment for possible confounding variables, logistic regression analysis showed that patients with sarcopenia and frailty had an increased likelihood of falls compared with those without (sarcopenia: OR = 3.24, 95 % CI: 1.18-8.88; frailty: OR = 1.46, 95 %CI: 1.14-1.87). It was also confirmed that higher IC scores were associated with a greater risk of falling (OR = 1.42, 95 %CI: 1.08-1.88).

CONCLUSIONS

The findings showed that complications such as sarcopenia, frailty, and decreased IC were associated with falls in patients with stable schizophrenia, and that these conditions are common in this populations. It is recommended that clinicians and medical personnel be aware of these associations in patient management.