Risk Factors for Falls in Older Disabled Women With Diabetes: The Women's Health and Aging Study
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BACKGROUND: The aim of this study was to determine whether older disabled women with diabetes have an increased risk of falls compared to women without diabetes and to identify fall risk factors among this high-risk subgroup of patients. METHODS: Data are from the Women's Health and Aging Study I (n = 1002, age > or = 65 years), a prospective, population-based cohort study of the one third most disabled women in the Baltimore (MD) urban community-dwelling population. Participants were followed semiannually for 3 years. Falls were ascertained at each interview. Diabetes was ascertained by means of a standardized algorithm using multiple sources of information. RESULTS: Baseline prevalence of diabetes was 15.5%. Of the 878 women who participated in at least one follow-up visit and were able to walk at baseline, 64.9% fell at least once during the study and 29.6% experienced two or more falls during a follow-up interval. After adjustment for traditional risk factors, women with diabetes had a higher probability of any fall (odds ratio [OR] 1.38; 95% confidence interval [CI], 1.04-1.81) and of falling two or more times during a follow-up interval (OR 1.69; CI, 1.18-2.43), compared with women without diabetes. Among diabetic women, presence of widespread musculoskeletal pain (OR 5.58; CI, 1.89-16.5), insulin therapy (OR 2.02; CI, 1.10-3.71), overweight (OR 3.50; CI, 1.21-10.1), and poor lower-extremity performance (OR 7.76; CI, 1.03-58.8) were independently associated with increased likelihood of recurrent falls, after adjusting for major risk factors. There were synergistic effects of diabetes and lower-extremity pain and also diabetes and body mass index levels on the risk of falling (p for interactions <.05). CONCLUSION: Even among disabled older women diabetes is associated with an increased risk of falling, independent of established fall risk factors. In this specific group of older women, pain, high body mass index, and poor lower-extremity performance are powerful predictors of falling.
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Other medical conditions that commonly accompany diabetes (CAD, obesity, degenerative joint disease, stroke, depression, visual impairment) negatively impact physical activity and functionality.
“Other medical conditions that commonly accompany diabetes such as CAD, obesity, degenerative joint disease, stroke, depression and visual impairment also negatively impact physical activity and functionality69.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [69]
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- Authors
- Volpato, S., Leveille, S. G., Blaum, C., Fried, L. P., & Guralnik, J. M.
- Affiliations
- University of Ferrara (IT)
- Beth Israel Deaconess Medical Center (US)
- Harvard University (US)
- Johns Hopkins University (US)
- National Institutes of Health (US)
- Corresponding author
- Volpato, S.
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-12-01
- Volume
- 60
- Issue
- 12
- Pages
- 1539-1545
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC2366043
- OpenAlex
- W2162958307
- Cited by
- 203
- References
- 52
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 7 · 2023: 2 · 2022: 3 · 2021: 8 · 2020: 7 · 2019: 8 · 2018: 16 · 2017: 16 · 2016: 11 · 2015: 12 · 2014: 20 · 2013: 11 · 2012: 18
- FWCI
- 20.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Funders
- Università degli Studi di Ferrara
- National Institute on Aging (P01AG004390)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- falls, fall risk factors, diabetes mellitus, older women, disability, recurrent falls, musculoskeletal pain, insulin therapy, overweight, body mass index, lower extremity performance, Women's Health and Aging Study
- MeSH terms
- Accidental Falls, Aged, Aged, 80 and over, Diabetes Mellitus, Female, Follow-Up Studies, Persons with Disabilities, Humans, Risk Factors
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