@article{ref1,
title="Risk of hospitalized falls and hip fractures in 22,103 older adults receiving mental health care vs 161,603 controls: a large cohort study",
journal="Journal of the American Medical Directors Association",
year="2020",
author="Stubbs, Brendon and Perara, Gayan and Koyanagi, Ai and Veronese, Nicola and Vancampfort, Davy and Firth, Joseph and Sheehan, Katie and De Hert, Marc and Stewart, Robert and Mueller, Christoph",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: To investigate the risk of hospitalized fall or hip fracture among older adults using mental health services. <br><br>DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: Residents of a South London catchment aged >60 years receiving specialist mental health care between 2008 and 2016. MEASURES: Falls and/or a hip fracture leading to hospitalization were ascertained from linked national records. Incidence rates and incidence rate ratios (IRRs) were age- and gender-standardized to the catchment population. Multivariable survival analyses were applied investigating falls and/or hip fractures as outcomes. <br><br>RESULTS: In 22,103 older adults, incidence rates were 60.1 per 1000 person-years for hospitalized falls and 13.7 per 1000 person-years for hip fractures, representing standardized IRRs of 2.17 [95% confidence interval (CI) 2.07-2.28] and 4.18 (3.79-4.60), respectively. The IRR for falls was high in those with substance-use disorder [IRR = 6.72 (5.35-8.33)], bipolar disorder [IRR = 3.62 (2.50-5.05)], depression [IRR = 2.28 (2.00-2.59)], and stress-related disorders [IRR = 2.57 (2.10-3.11)]. Hip fractures were increased in all populations (IRR > 2.5), with greatest risk in substance use disorders [IRR = 12.64 (7.22-20.52)], dementia [IRR = 4.38 (3.82-5.00)], and delirium [IRR = 4.03 (3.00-5.29)]. Comparing mental disorder subgroups with each other, after the adjustment for 25 potential confounders, patients with dementia and substance use had a significantly increased risk of falls, and patients with dementia also had an increased risk of hip fractures. <br><br>CONCLUSION AND IMPLICATIONS: Older people using mental health services have more than double the incidence of falls and 4 times the incidence of hip fractures compared to the general population. Although incidences differ between diagnostic subgroups, all groups have a higher incidence than the general population. Targeted interventions to prevent falls and hip fractures among older adult mental health service users are urgently needed.<br><br>Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1525-8610",
doi="10.1016/j.jamda.2020.03.005",
url="http://dx.doi.org/10.1016/j.jamda.2020.03.005"
}