title: Chronic kidney disease and recurrent falls in nursing home residents: a retrospective cohort study.
abstract: This study examined whether chronic kidney disease (CKD) is associated with recurrent falls in older adults in nursing homes (NHs). We used data abstracted over a six month period from 510 NH residents with a history of falls. Thirty-five percent of the NH residents had CKD. In adjusted analyses, the incidence of recurrent falls was similar in those with and without CKD [fall rate ratio (FRR) 1.00, 95% confidence interval (CI) 0.97-1.02]. Orthostatic hypotension (FRR 1.52, 95% CI 1.12-2.05), history of falls during the prior six month period (FRR 1.25, 95% CI 1.05-1.49), cane or walker use (FRR 1.64, 95% CI 1.16-2.33), and ambulatory dysfunction (FRR 1.47, 95% CI 1.23-1.75) were independently associated with increased fall rate. CKD was not an important predictor of falls in this cohort of nursing home residents with prior falls. Instead, traditional fall risk factors were much more strongly associated with recurrent falls.
authors.affiliation: Duke University Medical Center, Division of Nephrology, Department of Medicine, Box DUMC 2747, 2424 Erwin Road Suite 605, Durham, NC 27710, USA; Durham VA Geriatric Research, Education and Clinical Center, 508 Fulton Street, Durham, NC 27705, USA. Electronic address: rasheeda.stephens@dm.duke.edu.
authors.forename: Rasheeda K
authors.initials: RK
authors.lastname: Hall
authors.affiliation: Duke University Medical Center, Division of Geriatrics, Department of Medicine, Box DUMC 3003, Durham, NC 27710, USA; Duke University School of Nursing, DUMC Box 3322, 307 Trent Drive, Durham, NC 27710, USA.
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Landerman
authors.affiliation: VA Puget Sound Healthcare System, Department of Medicine and HSR&D Center of Excellence, 1660 S. Columbian Way, Seattle, WA 98108, USA; University of Washington, Division of Nephrology, Department of Medicine, 1959 NE Pacific Street, Box 356521, HSB, BB1271, Seattle, WA 98195, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: O'Hare
authors.affiliation: Duke University School of Nursing, DUMC Box 3322, 307 Trent Drive, Durham, NC 27710, USA.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Anderson
authors.affiliation: Durham VA Geriatric Research, Education and Clinical Center, 508 Fulton Street, Durham, NC 27705, USA; Duke University Medical Center, Division of Geriatrics, Department of Medicine, Box DUMC 3003, Durham, NC 27710, USA.
authors.forename: Cathleen S
authors.initials: CS
authors.lastname: Colón-Emeric
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Frail elderly; Renal insufficiency; Skilled nursing facility