Falls and Fractures in Community Dwelling Elderly Cancer SurvivorsOncology Nursing Society (2011)
Significance & Background:
Cancer survivors are living longer, but continue to encounter physical, psychosocial, and economic impacts of cancer until end of life. Of all types of injuries, falls pose the most serious threat to quality of life in the elderly.
Purpose: The purpose of this study was to examine the impact of a cancer diagnosis on falls and fractures.
Conceptual Framework: An aging and nursing model of care were synthesized.
Methods & Analysis:
This is a longitudinal, retrospective, study comparing 865 with cancer to 8617 without cancer. We analyzed data from the Michigan Home and Community Based Services program Minimum Data Set and Cancer Registry for 2002-2007. In this vulnerable, disparate community-dwelling elderly patient population, we compared those with and without a cancer diagnosis on falls and fractures. Generalized Estimating Equations modeling was used.
Findings & Implications:
Mean age was 77.1 years, 67.8% female, 74.0% Caucasian. Cancer diagnosis was 92.7% stage 2 or later. Cancer survivors’ fall rate was 32.7% compared to 29.4% in those without cancer. Adjusted odds ratios (ORs) of falls were: 1.16 (95% Confidence Interval [CI]=1.02, 1.33) for those with cancer versus those without cancer; 1.12 (95% CI=1.03, 1.22) for male versus female, 1.29 (95% CI=1.19, 1.40) for antidepressants versus none, 1.53 (95% CI=1.41, 1.65) short-term memory recall problems versus none, 1.45 (95% CI=1.32, 1.59) for evidence of pain daily versus none, 1.56 (95% CI=1.37, 1.77) for weight loss versus none, and 1.07 (95% CI=1.04, 1.12) for comorbidities versus none. ORs for increased fractures were 1.28 (95% CI= 1.17, 1.40) for daily pain versus none, and 1.61 (95% CI=1.11, 1.22) for comorbidities versus none. The odds were smaller with age OR= 0.95 (95% CI=0.87, 0.99), for males versus females 0.76 (95% CI=0.67, 0.69), African Americans versus Whites 0.36 (95% CI=0.26, 0.51), and short-term memory recall problems versus none 0.91 (95% CI=0.83, 1.00). Cancer survivors fell at a higher rate, and the risk of fall was higher closer to the date of cancer diagnosis; however, fractures (p >.05) did not occur more. As elderly cancer survivor’s transition through life, clinicians need to be aware that these patients are prone to increased falls, assess risk, and implement fall prevention measures.
Publication DateSpring 2011
Citation InformationSandra Spoelstra. "Falls and Fractures in Community Dwelling Elderly Cancer Survivors" Oncology Nursing Society (2011)
Available at: http://works.bepress.com/sandra-spoelstra/21/