Falls in people with chronic obstructive pulmonary disease: an observational cohort study.
OBJECTIVE
To investigate incidence, risk factors and impact of falls on health related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD).


METHODS
Observational cohort study.


METHODS
Patients completed these questionnaires at baseline and at 6-months: Medical Outcomes Study Short Form 36 (SF-36), Chronic Respiratory Questionnaire (CRQ), Activities Balance Confidence (ABC) Scale and a form to record demographic data, medications, co-morbidities, oxygen use, acute exacerbations, fall history and assistive device use. Physical activity was measured with the Physical Activity Scale for the Elderly (PASE) only at baseline. Fall incidence was monitored through monthly fall diaries. Patients were categorized as non-fallers (0 falls) or fallers (≥ 1 falls).


RESULTS
Data from 101 patients with a forced expiratory volume in 1 s of 46.4 ± 21.6% predicted were analyzed. Thirty-two patients (31.7%) reported at least one fall during the 6-months. Fall incidence rate was 0.1 (95% CI: 0.06-0.14) falls per person-month. Fallers tended to be older (p = 0.04), female (p = 0.04) and oxygen dependent (p = 0.02), have a history of previous falls (p < 0.001), more co-morbidities (p = 0.007) and take more medications (p = 0.001). Previous falls (OR = 7.36; 95% CI: 2.39-22.69) and diagnosis of coronary heart disease (OR = 7.07; 95% CI: 2.14-23.36) were the most important predictors of falls. The Dyspnea Domain of the CRQ declined significantly more (p = 0.02) in the fallers group at 6-months.


CONCLUSIONS
Patients with COPD have a high susceptibility to falls, which is associated with a worsening of dyspnea perception as related to HRQoL. Fall prevention programs in COPD are recommended.
Roig
M
M
Department of Physical Therapy, University of British Columbia, Vancouver, Canada. anand.a.dalal@gsk.com
Eng
J J
JJ
MacIntyre
D L
DL
Road
J D
JD
FitzGerald
J M
JM
Burns
J
J
Reid
W D
WD
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D020233:Gait Disorders, Neurologic / Q000150:complications / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D018908:Muscle Weakness / Q000150:complications / Q000453:epidemiology; D010102:Oxygen Inhalation Therapy; D004856:Postural Balance / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires