Falls in patients with chronic obstructive pulmonary disease: a call for further research.
Chronic obstructive pulmonary disease (COPD) is a respiratory disease that results in airflow limitation and respiratory distress. The effects of COPD, however, are not exclusively limited to respiratory function and people with COPD face many non-respiratory manifestations that affect both function and mobility. Deficits in function and mobility have been associated with an increased risk for falling in older adults. The purpose of this study was to provide a theoretical framework to identify risks factors for falls in people with COPD. We have analyzed the literature to identify possible relationships between pathophysiological changes observed in COPD and common risk factors for falls. Well-established fall risk factors in people with COPD include lower limb muscle weakness and impaired activities of daily living. Other intrinsic risk factors such as gait and balance deficits, nutritional depletion, malnutrition, depression, cognitive impairments and medications are possible risk factors that need to be confirmed with more studies. There is no evidence that visual deficits are common in COPD. The role that precipitating factors such as syncope and postural hypotension may have on fall risk is unclear. Exacerbations and dyspnea do not have a precipitating effect on fall risk but they contribute to the progressive physical deterioration that may theoretically increase the risk for falls. While these results suggest that people with COPD might have an increased susceptibility to fall compared to their healthy peers, further research is needed to determine the prevalence of falls and specific risk factors for falls in people living with COPD.
Department of Physical Therapy, University of British Columbia, 828 West 10th Avenue, Vancouver, Canada. markredj@interchange.ubc.ca
Marc
M
Roig
Janice J
JJ
Eng
Jeremy D
JD
Road
W Darlene
WD
Reid
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D003072:Cognition Disorders / Q000150:complications; D064420:Drug-Related Side Effects and Adverse Reactions; D020233:Gait Disorders, Neurologic / Q000150:complications; D006801:Humans; D044342:Malnutrition / Q000150:complications; D018908:Muscle Weakness / Q000150:complications; D004856:Postural Balance / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012678:Sensation Disorders / Q000150:complications; D014786:Vision Disorders / Q000150:complications