Risk of Hospitalized Falls and Hip Fractures in 22,103 Older Adults Receiving Mental Health Care vs 161,603 Controls: A Large Cohort Study.
Brendon Stubbs, Gayan Perara, Ai Koyanagi and 7 others
PMID 32321678WHAT IT FOUND
Older adults using mental health services had twice the rate of hospitalized falls and 4 times the rate of hip fractures compared with local residents.
Substance use, bipolar disorder, dementia, mild cognitive impairment, and delirium carried particularly high risk.
Key findings
01In the year after diagnosis, 1708 hospitalized falls and 424 hip fractures occurred among 22,103 older adults receiving mental health care.
02Compared with the general population, the age- and gender-adjusted incidence rate ratio was 2.17 for hospitalized falls and 4.18 for hip fractures.
03Substance use disorder had the highest increase compared with the general population for hospitalized falls (incidence rate ratio 6.72) and hip fractures (incidence rate ratio 12.62).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study counted only falls and hip fractures that led to hospital admission, so milder falls and fractures were not included. It did not collect information on mobility and balance before the event, which are key fall risk factors. It was observational, so it cannot show that a mental health diagnosis caused the higher rates. Some diagnostic groups were small, and 31% of patients had missing data on at least one covariate, which was imputed. The patient cohort was followed from diagnoses between 2008 and 2016, while the general population comparison used 2011 admissions and census denominators.
Declared interests
The supplied text does not include a funding or conflict-of-interest declaration; the publication types note research support, non-U.S. government.
The easy way to misread this
Do not conclude that mental health care itself caused the higher fall and fracture rates. The study was observational, did not measure mobility and balance, and only counted outcomes severe enough to need hospital admission.