Roberts, Jimmie
(2024)
Identifying Risk Factors of Fall Risk Increasing Drug Use and Fall and Fall Injury Risk in Racially and Ethnically Diverse Adults Over 50.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
BACKGROUND: Over 25% of older adults (65 years) fall every year, which can lead to injuries and disability. Fall risk increasing drugs (FRIDs), frequently defined through the Swedish National Board of Health and Welfare (SNBHW) and the CDC’s STEADI-Rx, are often initiated in midlife and have increased in prevalence among older adults mainly due to antihypertensive, antidepressant, and anticonvulsant use. Whether factors associated with use of FRIDs differ by definition is unknown. Additionally, associations between FRIDs and fall/fall injury risk are not fully understood in midlife or the oldest ages.
OBJECTIVES: This dissertation aimed to: identify risk factors associated with FRID use in older adults using SNBHW and STEADI-Rx definitions; and determine the association of FRIDs on self-reported fall/fall injury risk in Black and White men and women 79 years, and in multi-ethnic middle-age and early-old-age women.
METHODS: Participants included community-dwelling older adults in the Health, Aging, and Body Composition (Health ABC) Study (n=1352, 83±3 years) and those with <=2 years follow-up (n=1273, 83±4 years) for falls/fall injuries; and community-based multi-ethnic middle-age and early-old-age women in the Study of Women’s Health Across the Nation (SWAN, n=2010, Visits 13/14 and 15, 62±4 years). Multivariable logistic regression and negative binomial regression modeled risk factors associated with FRID use (yes/no) and count, respectively, for Health ABC. Multivariable generalized estimating equations modeled FRID use/count for fall/fall injury risk in Health ABC and SWAN.
RESULTS: Risk factors of FRID use were similar across definitions, including lifestyle/behavioral factors and conditions of multimorbidity. After removing antihypertensives from the STEADI-Rx definition, other FRID use and higher FRID count were associated with higher fall and fall injury risk vs. no falls in adults >=79 years. Among midlife and early-old-age women, physical activity or depressive symptoms, body pain, and vitality attenuated the association of FRID use and count, respectively, with fall injury risk to non-significance.
CONCLUSIONS: Results suggest activity or depressive symptoms, body pain, and vitality explains the associations of FRID use with fall/fall injury risk in midlife and early-old-age women, but not among adults >=79 years. Future interventions should evaluate fall/fall injury prevention through deprescribing FRIDs in older adults.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
16 May 2024 |
| Date Type: |
Publication |
| Defense Date: |
22 April 2024 |
| Approval Date: |
16 May 2024 |
| Submission Date: |
25 April 2024 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
243 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
FRID, medications, falls, injury, older adults, midlife |
| Date Deposited: |
16 May 2024 17:49 |
| Last Modified: |
16 May 2024 17:49 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46318 |
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