Stubbs_et_al_2020.pdf (300.69 kB)
Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study
journal contribution
posted on 2023-07-26, 15:17 authored by Brendon Stubbs, Gayan Perara, Ai Koyanagi, Nicola Veronese, Davy Vancampfort, Joseph Firth, Katie Sheehan, Marc De Hert, Robert Stewart, Christoph MuellerObjectives:
To investigate the risk of hospitalized fall or hip fracture among older adults using mental health services.
Design:
Retrospective cohort study.
Setting and Participants:
Residents of a South London catchment aged >60 years receiving specialist mental health care between 2008 and 2016.
Measures:
Falls and/or a hip fracture leading to hospitalization were ascertained from linked national records. Incidence rates and incidence rate ratios (IRRs) were age- and gender-standardized to the catchment population. Multivariable survival analyses were applied investigating falls and/or hip fractures as outcomes.
Results:
In 22,103 older adults, incidence rates were 60.1 per 1000 person-years for hospitalized falls and 13.7 per 1000 person-years for hip fractures, representing standardized IRRs of 2.17 [95% confidence interval (CI) 2.07-2.28] and 4.18 (3.79-4.60), respectively. The IRR for falls was high in those with substance-use disorder [IRR = 6.72 (5.35-8.33)], bipolar disorder [IRR = 3.62 (2.50-5.05)], depression [IRR = 2.28 (2.00-2.59)], and stress-related disorders [IRR = 2.57 (2.10-3.11)]. Hip fractures were increased in all populations (IRR > 2.5), with greatest risk in substance use disorders [IRR = 12.64 (7.22-20.52)], dementia [IRR = 4.38 (3.82-5.00)], and delirium [IRR = 4.03 (3.00-5.29)]. Comparing mental disorder subgroups with each other, after the adjustment for 25 potential confounders, patients with dementia and substance use had a significantly increased risk of falls, and patients with dementia also had an increased risk of hip fractures.
Conclusion and Implications:
Older people using mental health services have more than double the incidence of falls and 4 times the incidence of hip fractures compared to the general population. Although incidences differ between diagnostic subgroups, all groups have a higher incidence than the general population. Targeted interventions to prevent falls and hip fractures among older adult mental health service users are urgently needed.
History
Refereed
- Yes
Volume
21Issue number
12Page range
1893-1899Publication title
Journal of the American Medical Directors AssociationISSN
1538-9375External DOI
Publisher
ElsevierFile version
- Published version
Language
- eng
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Legacy posted date
2021-02-26Legacy creation date
2021-02-26Legacy Faculty/School/Department
Faculty of Health, Education, Medicine & Social CareUsage metrics
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