title: Age- and gender-specific associations between insomnia and falls in Boston Puerto Rican adults.
abstract: This study evaluated the age- and gender-specific associations between insomnia and falls in community-dwelling Puerto Rican adults, independently of multiple covariates.
  
  
  
  Cross-sectional data were collected from 954 Puerto Ricans, aged 46-79 years, in Boston, Massachusetts. In-person interviews were conducted to collect information on sociodemographics and lifestyle, mental status, medication use, comorbidities, sleep duration, insomnia symptoms, and falls and fractures. Blood and urine samples, and bone density measures were collected to assess C-reactive protein, serum interleukin-6, urinary cortisol, and bone mineral density.
  
  
  
  Multivariate robust Poisson regressions suggested that adults with insomnia had a 32 % increased likelihood of having falls (PR 1.32, p < 0.05), after adjustment for multiple covariates. Age and gender modified the effect of insomnia on risk of falls. Insomnia was significantly associated with higher risk of falls in adults of 60 years or older (PR 1.49, p < 0.05) and in women (PR 1.36, p < 0.05), but not in adults younger than 60 years or in men. Insomnia was not associated with recurrent falls or fractures.
  
  
  
  Age and gender need to be taken into account when considering treatment of insomnia in preventing geriatric falls. Well-designed evidence-based interventions to treat insomnia and improve sleep quality may reduce the risk of falls in this population.
authors.affiliation: School of Nursing, University of Massachusetts Lowell, 113 Wilder Street, Lowell, MA, 01854, USA. Yuan_Zhang@uml.edu.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, USA.
authors.forename: Manuel
authors.initials: M
authors.lastname: Cifuentes
authors.affiliation: Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, 16802, USA.
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
authors.affiliation: School of Nursing, University of Massachusetts Lowell, 113 Wilder Street, Lowell, MA, 01854, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Amaral
authors.affiliation: Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, 3 Solomont Way, Lowell, MA, 01854, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D001900:Boston; D003430:Cross-Sectional Studies; D005260:Female; D005783:Gender Identity; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D011647:Puerto Rico; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*
keywords: Accidental falls; Hispanics; Recurrent falls; Sleep disorders; Sleep medication