title: Falls and fall-related injury are common in older people with chronic liver disease.
abstract: BACKGROUND
  Improved survival with chronic liver disease (CLD) and increased incidence in the older has led to a rapidly expanding population which faces similar "geriatric syndromes" as the general population. With risk factors such as autonomic dysfunction, cognitive impairment, and muscle abnormalities in CLD it is expected that falls and injury will be common.
  
  
  OBJECTIVE
  To determine prevalence of falls and injury in chronic liver disease and to identify potential modifiable fall associations.
  
  
  METHODS
  Falls prevalence was estimated by providing patients aged ≥ 65 years with CLD a falls data collection tool, via the post or in the clinic. A younger CLD cohort and age-matched and sex-matched community controls was used for comparison. A sub-group underwent multidisciplinary falls assessment to identify modifiable fall associations.
  
  
  RESULTS
  Falls were significantly more common in older people with CLD (47 % in previous year) than in controls; incidence of injury did not differ. Regression identified orthostatic symptoms, lower-limb strength, and fear of falling as being independently associated with falls in CLD. Those who had fallen had significantly greater difficulty with daily activities.
  
  
  CONCLUSIONS
  Falls are prevalent in older people with CLD, and are potentially preventable with multifactorial intervention. Services must prepare for expansion in the older CLD population; here we demonstrate how this expansion may affect falls services and provide a potential therapeutic target.
authors.affiliation: UK National Institute for Health Research, Biomedical Research Centre in Ageing-Liver Theme, Newcastle University, Newcastle, NE1 7RU, UK. james.frith@ncl.ac.uk
authors.forename: James
authors.initials: J
authors.lastname: Frith
authors.forename: Simon
authors.initials: S
authors.lastname: Kerr
authors.forename: Lisa
authors.initials: L
authors.lastname: Robinson
authors.forename: Chris S
authors.initials: CS
authors.lastname: Elliott
authors.forename: Katharine
authors.initials: K
authors.lastname: Wilton
authors.forename: David E J
authors.initials: DE
authors.lastname: Jones
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Day
authors.forename: Julia L
authors.initials: JL
authors.lastname: Newton
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D004244:Dizziness / Q000150:complications; D058625:End Stage Liver Disease / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D055815:Young Adult