Risk factors of falls and the gender differences in older adults with diabetes at outpatient clinics

Abstract

Aims To explore the risk factors of falls and the gender differences based on demographic and disease characteristics, physical capability, and fear of falling in older adults with diabetes visiting outpatient clinics in Taiwan. Design Cross‐sectional design. Methods A total of 485 patients with type 2 diabetes aged between 65 and 80 years were recruited from three endocrine outpatient clinics in Taiwan. Demographic and disease characteristics, fall history in the previous one year and fear of falling were collected by a self‐reported questionnaire. Calf circumference, handgrip strength, one‐leg standing and time up‐and‐go tests were all performed to assess the physical capability of participants. Data were collected from May 2019 to May 2020. Results Female gender (OR = 1.75), handgrip strength (OR = 2.43) and fear of falling (OR = 3.38) were important risk factors of falls overall, although fear of falling (OR = 4.69) was the only important risk factor of falls in males, while handgrip strength (OR = 3.48) and fear of falling (OR = 2.86) were important risk factors of falls in females. The sensitivity of simultaneous screening handgrip strength and fear of falling were 85.7, 86.4 and 86.2 in males, females and older adults overall with diabetes, respectively. Conclusion Fear of falling was an important risk factor of falls in both genders, especially in males. Handgrip strength was an important risk factor of falls specifically for females. By simultaneously screening fear of falling and handgrip strength, risk of falls in older adults with diabetes at outpatient clinics could be identified in a more timely manner. Impact Nurses could periodically and simultaneously assess fear of falling and handgrip strength of older adults with diabetes at outpatient clinics. For those are identified at risk of falls on either fear of falling or handgrip strength, nurses could provide corresponding interventions to reduce the fear of falling or improve muscle strength to prevent such falls.

Mapping sex and gender differences in falls among older adults: A scoping review

“…Searching five electronic databases yielded a total of 15,266 unique articles after the removal of duplicates. We reviewed 561 full‐text articles for eligibility and 74 articles were included in this scoping review 13,23–95 . The majority of the articles were excluded because their aim statements did not specifically mention falls, sex, and/or gender (see supplemental Tables S2 and S3 for the list of included and excluded studies, respectively).…”

“…Only three (4%) studies focused on populations with specific conditions, with two (3%) studies in older adults with rheumatoid arthritis, 44,66 and one (1%) study in older adults with Type 2 diabetes mellitus. 79 Another 42 (57%) studies included populations with multiple different conditions. Lastly, 29 (39%) studies did not report any conditions in their populations.…”

“…The mean ages and characteristics of participants included in the studies are shown in Table 3. Only three (4%) studies focused on populations with specific conditions, with two (3%) studies in older adults with rheumatoid arthritis, 44,66 and one (1%) study in older adults with Type 2 diabetes mellitus 79 . Another 42 (57%) studies included populations with multiple different conditions.…”

An “Engage to Sustain” Intervention to Improve Process Performance Measures in Ambulatory Care

“…Among Medicare beneficiaries 65 years and older (N = 47 215) receiving care for fall-related injuries, 72% failed to report this injury when asked (Hoffman et al, 2018). Gender differences also exist for patient-reported falls in older adults, with females showing a higher risk (Fabre et al, 2010;Hoffman et al, 2018Hoffman et al, , 2022Wang et al, 2021). Screening practices and rates vary considerably in ambulatory care from use of a single screening question to use of a fall risk instrument or scale.…”