Do older adults with cancer fall more often? A comparative analysis of falls in those with and without cancer

Abstract

Purpose/objectives: To examine whether a history of cancer increased the likelihood of a fall in community-dwelling older adults, and if cancer type, stage, or time since diagnosis increased falls.

Design: A longitudinal, retrospective, cohort study.

Setting: A home- and community-based waiver program in Michigan.

Sample: 862 older adults aged 65 years or older with cancer compared to 8,617 older adults without cancer using data from the Minimum Data Set-Home Care and Michigan cancer registry.

Methods: Reports of falls were examined for 90-180 days. Generalized estimating equations were used to compare differences between the groups.

Main research variables: Cancer, falls, patient characteristics, comorbidities, medications, pain, weight loss, vision, memory recall, and activities, as well as cancer type, stage, and time since diagnosis.

Findings: A fall occurred at a rate of 33% in older adults with cancer compared to 29% without cancer (p < 0.00). Those with a history of cancer were more likely to fall than those without cancer (adjusted odds ratio 1.16; 95% confidence interval [1.02, 1.33]; p = 0.03). No differences in fall rates were determined by cancer type or stage, and the odds of a fall did not increase when adding time since cancer diagnosis.

Conclusions: The fall rate was higher in older adults with cancer than in older adults without cancer.

Implications for nursing: Nurses need to assess fall risk and initiate fall prevention measures for older adults at the time of cancer diagnosis.

Knowledge translation: When caring for older adults with cancer, nurses should be aware of an increased risk for falls. Healthcare staff also should be aware of an increased risk for falls in that population during cancer treatment. Evidence-based fall prevention measures should be included in care plans for older adult cancer survivors.