The Casual Association Inference for the Chain of Falls Risk Factors-Falls-Falls Outcomes: A Mendelian Randomization Study

Abstract

Previous associations have been observed not only between risk factors and falls but also between falls and their clinical outcomes based on some cross-sectional designs, but their causal associations were still largely unclear. We performed Mendelian randomization (MR), multivariate Mendelian randomization (MVMR), and mediation analyses to explore the effects of falls. Our study data are mainly based on White European individuals (40–69 years) downloaded from the UK Biobank. MR analyses showed that osteoporosis (p = 0.006), BMI (p = 0.003), sleeplessness (p < 0.001), rheumatoid arthritis (p = 0.001), waist circumference (p < 0.001), and hip circumference (p < 0.001) have causal effects on falls. In addition, for every one standard deviation increase in fall risk, the risk of fracture increased by 1.148 (p < 0.001), the risk of stroke increased by 2.908 (p = 0.003), and a 1.016-fold risk increase in epilepsy (p = 0.009). The MVMR found that sleeplessness is an important risk factor for falls. Finally, our mediation analyses estimated the mediation effects of falls on the hip circumference and fracture (p < 0.001), waist circumference and epilepsy (p < 0.001), and sleeplessness and fracture (p = 0.005). Our study inferred the causal effects between risk factors and falls, falls, and outcomes, and also constructed three causal chains from risk factors → falls → falls outcomes.

Comparison of Risk Factors for Falls in the Old and the Oldest Old Admitted to the Emergency Department

“…The fact that the frequency of walking aid use was much higher in our study also strengthens this hypothesis. It has already been observed in studies that the presence and degree of frailty is closely related to falls (14). We did not find a statistically significant difference between the old and the oldest old in terms of history of fall (p=0.714), while fear of falling was significantly higher in the oldest old group (p=0.007).…”

“…In our study, we demonstrated that falls occur more frequently with increasing age. Advanced age is an important risk factor for falls (14). With increasing age, changes in the neuromuscular system, malnutrition, geriatric syndromes such as sarcopenia, and visual problems occur and cause falls (15).…”

Causal associations between genetically determined common psychiatric disorders and the risk of falls: evidence from Mendelian randomization

“…Previous studies have affirmed significantly correlation between genetically determined body mass index (BMI) and the initiation of smoking (whether an individual had ever smoked regularly) with the risk of falls [ 27 , 28 ]. BMI and smoking initiation are modifiable factors in daily life.…”

Quality of Information in Osteoporosis Videos on TikTok: Cross-sectional Study (Preprint)

“…In China, the prevalence ranges from 0.89% to 17.23% among people aged 18 to 75 [3]. Osteoporosis can lead to falls, and there is a certain causal relationship between them [4]. A systematic analysis of the Global Burden of Disease Study 2021 indicated that falls are one of the leading causes of age-standardized mortality globally, with 9.9 deaths per 100,000 people [5].…”