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Risk factors for falls in older patients with cancer
  1. Xiaotao Zhang1,
  2. Ming Sun1,
  3. Suyu Liu2,
  4. Cheuk Hong Leung2,
  5. Linda Pang1,
  6. Uday R Popat3,
  7. Richard Champlin4,
  8. Holly M Holmes5,
  9. Vicente Valero6,
  10. Colin P Dinney7,
  11. Debu Tripathy6 and
  12. Beatrice J Edwards1
  1. 1Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
  2. 2Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
  3. 3Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
  4. 4Stem Cell Transplantation and Cellular Therapy Center, The University of Texas MD Anderson Cancer Center, Houston, USA
  5. 5Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Texas Houston McGovern Medical School, Houston, USA
  6. 6Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
  7. 7Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, USA
  1. Correspondence to Dr Beatrice J Edwards, Department of General Internal Medicine, Unit 1465 The University of Texas MD Anderson Cancer Center 1400 Pressler Houston, TX 77030; USA; BEdwards{at}mdanderson.org

Abstract

Objectives A rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer.

Methods This is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment. Vitamin D and bone densitometry were performed.

Analysis Descriptive statistics and multivariable logistic regression.

Results A total of 304 patients aged 65 or above were enrolled in this study. The mean age was 78.4±6.9 years. They had haematological, gastrointestinal, urological, breast, lung and gynaecological cancers. A total of 215 patients with available information about falls within the past 6 months were included for final analysis. Seventy-seven (35.8%) patients had at least one fall in the preceding 6 months. Functional impairment (p=0.048), frailty (p<0.001), dementia (p=0.021), major depression (p=0.010) and low social support (p=0.045) were significantly associated with the fall status in the univariate analysis. Multivariate logistic regression analysis identified frailty and functional impairment to be independent risk factors for falls.

Conclusions Falls are common in older patients with cancer and lead to adverse clinical outcomes. Major depression, functional impairment, frailty, dementia and low social support were risk factors for falls. Heightened awareness and targeted interventions can prevent falls in older patients with cancer.

  • comorbidity
  • depression
  • dementia
  • alzheimers disease
  • frailty
  • activities of daily
  • living,fractures
  • neoplasias
  • aging
  • hospitalization
  • injuries
  • Received 12 June 2017.
  • Revision received 27 July 2017.
  • Accepted 2 August 2017.

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Footnotes

  • Contributors BJE developed the study concept, designed the study, monitored the study and revised the manuscript. XZ collected the data, cleaned the data, analysed the data, interpreted the data, drafted the manuscript and revised the manuscript. MS collected the data and revised the manuscript. SL and CHL created the statistical analysis plan and analysed the data. All other coauthors (LP, URP, RC, HMH, VV, CPD and DT) reviewed the manuscript and gave comments and suggestions.

  • Funding We were funded by UT MD Anderson Cancer Center. We were in control of all the primary data, and these data could be available for analysis.

  • Competing interests None declared.

  • Ethics approval The University of Texas MD Anderson Cancer Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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