The multidimensional prognostic index predicts falls in older people: an 8-year longitudinal cohort study in the Osteoarthritis Initiative

Veronese, Nicola and Siri, Giacomo and Cella, Alberto and Maggi, Stefania and Zigoura, Ekaterini and Puntoni, Matteo and Smith, Lee and Musacchio, Clarissa and Barone, Antonella and Sabba, Carlo and Vallone, Francesco and Pilotto, Alberto (2019) The multidimensional prognostic index predicts falls in older people: an 8-year longitudinal cohort study in the Osteoarthritis Initiative. Journal of the American Medical Directors Association. ISSN 1538-9375

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Official URL: https://doi.org/10.1016/j.jamda.2019.10.002

Abstract

Objectives: Falls are associated with several negative outcomes. Early identification of those who are at risk of falling is of importance in geriatrics and comprehensive geriatric assessment (CGA) seems to be promising in this regard. Therefore, the present study investigated whether the multidimensional prognostic index (MPI), based on a standard CGA, is associated with falls in the Osteoarthritis Initiative (OAI). Design: Longitudinal, 8 years of follow-up. Setting and participants: Community-dwelling older people (> 65 years) with knee OA or at high risk for this condition. Methods: A standardized CGA including information on functional, nutritional, mood, comorbidities, medications, quality of life and co-habitation status was used to calculate a modified version of the MPI, categorized as MPI-1 (low), MPI-2 (moderate) and MPI-3 (high risk). Falls were self-reported and recurrent fallers were defined as >2 in the previous year. Logistic regression was carried out and results are reported as odds ratio (ORs), with their 95% confidence intervals (CIs). Results: The final sample consisted of 885 older adults (mean age 71.3 years, females=54.6%). Recurrent fallers showed a significant higher MPI than their counterparts (46.1±17.2 vs. 38.2±15.8; p<0.001). Compared to those in MPI-1 category, participants in MPI-2 (OR=2.13; 95%CI: 1.53-2.94; p<0.001) and in MPI-3 (OR=5.98; 95%CI: 3.29-10.86; p<0.001) reported a significant higher risk of recurrent falls over the 8-years of follow-up. Similar results were evident when using an increase in 0.1 points in the MPI or risk of falls after one year. Conclusions and implications: Higher MPI values at baseline were associated with an increased risk of recurrent falls suggesting the importance of CGA in predicting falls in older people.

Item Type: Journal Article
Keywords: multidimensional prognostic index, comprehensive geriatric assessment, falls, Osteoarthritis Initiative
Faculty: Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 08 Oct 2019 10:07
Last Modified: 02 Dec 2019 16:37
URI: http://arro.anglia.ac.uk/id/eprint/704843

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