Background
Falls and fall-related injuries are a major public health concern.
HIV-infected adults have been shown to have a high incidence of falls.
Identification of major risk factors for falls that are unique to HIV or
similar to the general population will inform development of future
interventions for fall prevention.
Methods
HIV-infected and uninfected men and women participating in a Hearing
and Balance Sub-study of the Multicenter AIDS Cohort Study and
Women’s Interagency HIV Study were asked about balance symptoms and
falls during the prior 12 months. Falls were categorized as 0, 1, or
≥ 2; proportional odds logistic regression models were used to
investigate relationships between falls and demographic and clinical
variables and multivariable models were created.
Results
24% of 303 HIV-infected participants reported ≥1 fall compared
to 18% of 233 HIV-uninfected participants (p=0.27). HIV-infected
participants were demographically different from HIV-uninfected
participants, and were more likely to report clinical imbalance symptoms
(p≤0.035). In univariate analyses, more falls were associated with
hepatitis C, female sex, obesity, smoking, and clinical imbalance symptoms,
but not age, HIV serostatus, or other comorbidities. In multivariable
analyses, female sex and imbalance symptoms were independently associated
with more falls. Among HIV-infected participants, smoking, number of
medications, and imbalance symptoms remained independent fall predictors
while current protease inhibitor use was protective.
Discussion
Similar rates of falls among HIV-infected and uninfected participants
were largely explained by a high prevalence of imbalance symptoms. Routine
assessment of falls and dizziness/imbalance symptoms should be considered,
with interventions targeted at reducing symptomatology.