COPD linked to greater risk for falls

By Lisa Rapaport

(Reuters Health) - Older people with chronic obstructive pulmonary disease (COPD) are more likely to suffer from falls if they also have other medical problems, previous tumbles or a longer history of smoking, a study from Australia suggests.

Past research has linked COPD to an increased risk of balance difficulties, muscle weakness, thinning bones, blackouts and falls.

Dr. Cristino Carneiro Oliveira, of University of Melbourne, and colleagues studied 41 people around 71 years old with COPD. Over the course of the year-long study, 40% of the patients had at least one fall, and most people who fell did so more than once.

"This is important as those who tend to fall multiple times are more vulnerable to fall-related injuries," Dr. Oliveira told Reuters Health by email.

Globally, more than 65 million people have moderate to severe COPD, and the condition causes about 5% of all deaths, according to the World Health Organization (WHO).

None of the patients in the current study had any neurological or musculoskeletal disorders or indications of frailty. At the start, about half the patients were on oxygen.

During the year, 41 falls were reported for 16 individuals. Most falls occurred indoors, often when people were standing and using their upper body at the same time. Loss of balance was the most common self-reported cause.

Thirteen falls resulted in only minor injuries like cuts and bruises. One person reported a hip fracture.

After adjusting for age, people had more than twice the risk of falling if they suffered from other medical problems in addition to COPD, and more than triple the risk if they had experienced a fall at some point in the year prior to the study.

Patients also had a small, but significantly greater risk of falls if they had a history of heavier smoking.

Patients who said they had a greater fear of falling also had a higher risk of realizing this fear, the study found.

The study is quite small, and additional larger studies are needed to more clearly understand the factors that may contribute to falls in people with COPD, the researchers acknowledge in the journal Respirology, July 23.

Even so, the findings add to a growing body of evidence highlighting the increased fall risk faced by COPD patients, Dr. Samantha Harrison, a researcher in respiratory medicine at West Park Healthcare Center in Toronto, who wasn't involved in the study said by email.

"We know that balance is impaired in individuals with COPD and poor balance is associated with an increased risk of falls," Harrison noted.

Workouts to improve balance and stability may help minimize this risk, she said.

"Participation in balance training delivered within a pulmonary rehabilitation program has been found to improve balance confidence and may have some impact on patients' fear of falling," Harrison added.

SOURCE: https://bit.ly/1h7trNN

Respirology 2015.