title: Multimorbidity predicts falls differentially according to the type of fall in postmenopausal women.
abstract: OBJECTIVE
  To ascertain whether the risk of falls of different types is related to morbidity (number of chronic medical conditions) among postmenopausal women.
  
  
  METHODS
  This cohort study uses data from a population-based prospective cohort study (OSTPRE). The study population consisted of 10,594 women aged 47-56 years living in Kuopio Province, Eastern Finland, in 1989, who responded to postal enquiries at both baseline and 5-year follow-up, in 1994. Morbidity (i.e. number of diagnosed chronic medical conditions) was reported in 1989 and falls in 1994. Falls were categorized as slip or nonslip, and 'frequent falls' was defined as two or more in a 12-month period.
  
  
  RESULTS
  The risk (odds ratio (OR) with 95% CI) of a fall increased with the number of chronic medical conditions. The OR was 1.28 (1.17-1.40) for those with 1-2 conditions and 1.41 (1.24-1.60) for those with multimorbidity (≥3 conditions) compared with healthy respondents. Multimorbidity was associated with a greater risk of the woman experiencing frequent nonslip falls (OR=2.57; 2.01-3.29) than frequent slip falls (OR=1.46; 1.17-1.80). Adjusting with logistic regression for age, number of medications and smoking did not affect the risk estimates.
  
  
  CONCLUSIONS
  Multimorbidity has a much smaller effect on slip than on nonslip falls in postmenopausal women. This should be taken into account when investigating the effects of multimorbidity on fall risk in varying weather conditions.
authors.affiliation: Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland. Electronic address: nadia.ziaul@gmail.com.
authors.forename: Nadia
authors.initials: N
authors.lastname: Afrin
authors.affiliation: Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland.
authors.forename: Risto
authors.initials: R
authors.lastname: Honkanen
authors.affiliation: Institute of Clinical Medicine, Psychiatry, UEF, Kuopio, Finland; Department of Psychiatry: Kuopio University Hospital (KUH), Kuopio; South-Savonia Hospital District, Mikkeli; North Karelia Central Hospital, Joensuu; SOSTERI, Savonlinna; SOTE, Iisalmi; Lapland Hospital District, Rovaniemi, Finland.
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.affiliation: School of Medicine, Faculty of Health Sciences, University of Eastern Finland (UEF), Kuopio, Finland.
authors.forename: Pyry
authors.initials: P
authors.lastname: Lukkala
authors.affiliation: Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland.
authors.forename: Toni
authors.initials: T
authors.lastname: Rikkonen
authors.affiliation: Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland; Department of Orthopaedics, Traumatology and Handsurgery, Kuopio University Hospital (KUH), Kuopio, Finland.
authors.forename: Joonas
authors.initials: J
authors.lastname: Sirola
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia.
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
authors.affiliation: Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio, Finland; Department of Orthopaedics, Traumatology and Handsurgery, Kuopio University Hospital (KUH), Kuopio, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Kröger
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016387:Women's Health
keywords: Fall; Morbidity; Multimorbidity; Risk factor; Slip