Diabetes
a Risk for Falling in the Elderly
Nursing home residents with diabetes are four times
more likely to fall than those who are not diabetic, according to a
study in the Journals of Gerontology.
Falling is the leading cause of accidental death
for elderly people. During November, American
Diabetes Month is recognized to focus on the needs of persons
with diabetes.
Currently, 150 million people are estimated to have
type 2 diabetes, and the number is expected to reach 300 million people
by 2025.
The study found that 78 percent of nursing home
residents who had diabetes fell within the 299-day study period, compared
to 30 percent of those without diabetes who had a similar fall.
The study followed 139 residents of the Hebrew Home
at Riverdale in New York.
Previous investigations have defined risk factors
for falls among frail, elderly nursing home residents, which include
gait or balance disorder, vision impairment, and medications, but until
now diabetes has not been widely recognized as an important risk factor.
"Our study clearly indicated that nursing homes,
assisted living facilities, and others that care for the elderly should
consider diabetes a significant risk factor for falling," says Dr.
Mathew S. Maurer, a researcher at Columbia University Medical Center.
"In an era of limited resources, knowing that diabetics
are more likely to fall may facilitate identifying older individuals
who are likely to benefit from interventions aimed at reducing falls
and their consequences," says Dr. Maurer, a geriatric cardiologist.
"We will now add diabetes to the list of risk factors
for falling and expect this to become standard practice," says Dr.
Robert Zorowitz, chief medical officer of the Hebrew Home at Riverdale,
where the study was conducted.
"By controlling diabetes, addressing the complications
it causes, and being vigilant about the other factors that contribute
to falls, we may substantially reduce the risk," explains Dr. Zorowitz.
Although complications from diabetes include the
drop of blood pressure when standing up, known as orthostatic hypotension,
as well as visual impairments, the study found that neither of these
were an explanation for the increased fall risk.
Dr. Maurer speculates that problems with peripheral
nerves that can affect the sensation in diabetic people's feet, known
as peripheral neuropathy, could be the mechanism at fault for the higher
fall rate in diabetic patients.
The study was originally intended to assess if predicting
fall risk could be improved by measuring blood pressure.
The researchers tried a new method that records
blood pressure continuously during the process of standing, rather
than the traditional method that uses a cuff to record blood pressure
while sitting and one or three minutes after standing.
The study showed that this kind of measurement did
not, in fact, help prediction, but instead showed that diabetes, in
addition to gait and balance difficulties, were the most potent predictors
of falling in this group of people.
The study was funded by the National
Institute on Aging and the American
Federation of Aging Research.
Always consult your physician for more information.
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