Generalized and localized osteoarthritis and risk of fall among older adults: the role of chronic diseases and medications using real world data from a single center

OBJECTIVE: This study exam-ined the prevalence of falls among older adults with generalized and localized osteoarthritis (OA) and identified the association between falls and both chronic diseases and medications. PATIENTS AND METHODS: A retrospective design using the Healthcare Enterprise Repos-itory for Ontological Narration (HERON) data-base was used. A cohort of 760 patients aged = 65 years with at least two diagnosis codes for either localized or generalized OA were includ-ed. The extracted data included demographics (age, sex, and race), body mass index (BMI), fall history, comorbid health conditions (i.e., type 2 diabetes, hypertension, dyslipidemia, neuropa-thy, cardiovascular diseases, depression, anxi-ety, and sleep disorders), and medications [i.e., pain medication (opioids, non-opioids), antidia-betics (insulin or hypoglycemic), antihyperten-sives, antilipemic, and antidepressants].RESULTS: The prevalence rates of falls and re-current falls were 27.77% and 9.88%, respective-ly. Individuals with generalized OA had a higher prevalence of falls (33.8%) than those with local-ized OA (24.2%). Multivariable logistic regression analysis showed that individuals with OA who had hypertension [odds ratio (OR): 1.86, 95% CI, (1.20, 2.89), p=0.006] and used antidepressants [OR: 1.72, 95% CI, (1.04, 2.84), p=0.035] were more likely to have a fall. Individuals with OA who had hypertension [OR: 2.69, 95% CI, (1.30, 5.60), p=0.008], neuropathy [OR: 4.95, 95% CI, (2.95, 11.68), p<0.001], and insulin [OR: 2.85, 95% CI, (1.12, 7.22), p=0.035] were more likely to have a recurrent fall (two or more falls).CONCLUSIONS: Falls are common in indi-viduals with generalized OA. Comorbid health conditions including hypertension and neurop-athy, need to be considered in the screening of the risk of fall. Fall risk needs to be considered when discussing medication prescriptions, es-pecially antidepressants and insulin.