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Risk of falls increases sharply in women during midlife

Interventions designed to prevent falls may need to start earlier, study suggests

Ingrid Torjesen

Wednesday, 22 August 2018

The risk of falls increases sharply after the age of 40, particularly in women, a study* published in the journal PLOS ONE has found.

The international study drew on data from TILDA (the Irish Longitudinal Study on Ageing) as well as data from similar studies in Australia, Great Britain and the Netherlands. In total, data on 19,207 men and women aged between 40 and 64 years were included.

Analysis of the data showed that for women the prevalence of falls increases from the age of 40, increasing by 9% in 40-44 year olds, 19% in 45-49 year olds, 21% in 50-54 year olds, 27% in 55-59 year olds and 30% in 60-64 year olds.

The findings indicate that middle-age may be a critical life stage for interventions designed to prevent falls, the researchers said.

Lead author of the study, Dr Geeske Peeters, Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute at Trinity College in Dublin, said that researchers and doctors assume that falls are a problem that only affects people above the age of 65.

“This study shows that the prevalence of falls is already quite high from the age of 50. In fact, our research shows that there is a sharp increase in the prevalence of falls in women during midlife. This occurs at a time that we also see an increase in the prevalence of common risk factors for falls, such as balance problems, diabetes and arthritis," he said.

"Current prevention strategies basically wait until people have developed risk factors and then try to make them go away. It may be better and more effective to prevent the risk factors, or to detect them at an early stage to reduce their consequences, particularly falls. We are now working with our research colleagues in the Netherlands, Australia and the UK to investigate whether there is scope to start prevention strategies before the age of 65 years."

Professor Rose Anne Kenny, senior author on the paper and director of TILDA and of the Falls Unit at St James Hospital, said that while falls can cause serious injury and result in disability, they also create fear of further falls.

“People who have a fear of falling or have had a fall are most at risk of falls and should be targeted for strength and balance programmes and medication reviews - both strategies significantly reduce falls."

The timing of the increases in falls coincides with the onset of the menopause, decline in balance performance, and increase in the presence of vertigo and fainting, all of which will also benefit from these falls prevention strategies, she said.

Dr Peeters said: "A better understanding of the factors that drive this increase in fall risk in middle age may be the key to effective prevention interventions earlier in life with potential benefits into older age. Further research should help us design the most appropriate strategies to prevent falls at this critical juncture in a person's life."

*Peeters G, Schoor NM van, Cooper R, et al. Should prevention of falls start earlier? Co-ordinated analyses of harmonised data on falls in middle-aged adults across four population-based cohort studies. PLOS ONE, DOI:10.1371/journal.pone.0201989

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