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Identifying Risk Factors of Fall Risk Increasing Drug Use and Fall and Fall Injury Risk in Racially and Ethnically Diverse Adults Over 50

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 (Unpublished)

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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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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Roberts, Jimmiejer183@pitt.edujer1830000-0002-3674-2554
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairStrotmeyer, Elsastrotmeyere@edc.pitt.edustrotmeyere
Committee MemberBuchanich, Jeaninejeanine@pitt.edujeanine
Committee MemberCauley, Janejcauley@edc.pitt.edujcauley
Committee MemberPruskowski, Jenniferjpruskow@pitt.edujpruskow
Committee MemberRuppert, Kristineruppertk@pitt.eduruppertk
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


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