title: Falls by individuals with chronic obstructive pulmonary disease: a preliminary 12-month prospective cohort study.
abstract: OBJECTIVE
  Despite evidence of an increased fall risk in people with chronic obstructive pulmonary disease (COPD), there is a paucity of prospective fall data in this population. This preliminary study aimed to prospectively examine the prevalence rate, incidence rate and associated risk factors for falls in a sample of community-dwelling people with COPD over 1 year.
  
  
  METHODS
  Forty-one participants with stable COPD (mean ± SD) aged 71 ± 8 years with a forced expiratory volume in 1 s of 45.1 ± 16.2% predicted were included. At baseline, participants' demographic, physical function and fall-related measures were documented. Falls were monitored for 12 months following initial assessments.
  
  
  RESULTS
  The prevalence of people having falls was 40% (95% CI: 24-56%); amongst these, 75% had frequent falls. The overall fall incidence rate was 1.17 falls/person-year. Risk factors associated with a higher fall incidence rate ratio (IRR) in COPD were: number of pack-years (IRR: 1.02; 95%CI: 1.00,1.04), comorbidities (IRR: 2.02; 95%CI: 1.42,3.06), number of medications (IRR: 1.15; 95%CI: 1.00,1.34), history of falls in the previous year (IRR: 1.89; 95%CI: 1.10,3.34), fear of falling (IRR: 1.08; 95% CI: 1.02,1.14) and higher score in a fall risk assessment questionnaire for older adults (IRR: 1.14; 95% CI: 1.05,1.25); P ≤ 0.05. When adjusted for age, only pack-years (P = 0.01), number of comorbidities (P < 0.001) and history of falls (P = 0.03) were related to an increased fall incidence.
  
  
  CONCLUSIONS
  These preliminary findings demonstrated the fall prevalence and incidence rate in community-dwelling people with stable COPD and identified prospective risk factors for an increased fall incidence, which suggest potential mitigation strategies.
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Cristino C
authors.initials: CC
authors.lastname: Oliveira
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Annemarie L
authors.initials: AL
authors.lastname: Lee
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McGinley
authors.affiliation: Department of Respiratory and Sleep Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Thompson
authors.affiliation: Lung Health Research Centre, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Respiratory and Sleep Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Louis B
authors.initials: LB
authors.lastname: Irving
authors.affiliation: Lung Health Research Centre, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Gary P
authors.initials: GP
authors.lastname: Anderson
authors.affiliation: School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Clark
authors.affiliation: Statistical Consulting Centre, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Sandy
authors.initials: S
authors.lastname: Clarke
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Denehy
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: accidental falls; chronic obstructive; epidemiology; pulmonary disease; risk factors