Complex comorbidity patterns in older adults with atrial fibrillation increased the 3-year risk of injurious falls compared to unspecific comorbidity patterns (HR 1.63; 95% CI 1.56-1.70).
Cohort (n=203,042)
Yes
Do specific comorbidity patterns increase the risk of injurious falls in older adults with atrial fibrillation?
In older adults with atrial fibrillation, specific comorbidity patterns, particularly complex and neuropsychiatric, significantly increase the risk of injurious falls, highlighting the need for targeted preventive interventions.
Effect estimate: HR 1.63 (95% CI 1.56-1.70)
BACKGROUND: Atrial fibrillation (AF) is associated with an increased fall risk, partly due to AF-related comorbidities. We investigated the impact of different comorbidity patterns on fall risk in older adults with AF. METHODS: Using the Swedish National Patient Register, we identified 203,042 adults (45 % females) with AF and at least one comorbidity, aged 65 years or older, on 01/01/2017. The primary study outcome was any fall requiring medical attention. Secondary outcomes were falls with fractures, falls with hip fractures, and falls with head trauma. Comorbidity patterns were identified through latent class analysis, and their association with 3-year fall risk was tested through Cox regressions. RESULTS: The sample mean age was 79.6 (SD: 7.9) years, and the mean number of chronic diseases was 6.6 (SD 3.2). We identified one unspecific (34.2 %) and six specific comorbidity patterns characterized by neuropsychiatric (6.6 %), eye (17.4 %), musculoskeletal (7.2 %), metabolic (15.8 %), cardiovascular (7.4 %), and complex (11.3 %) chronic conditions coexisting with AF. Older adults with AF and complex (HR=1.63, 95 %CI: 1.56-1.70), neuropsychiatric (HR=1.48, 95 %CI: 1.41-1.56), cardiovascular (HR=1.21, 95 %CI: 1.15-1.27), eye (HR=1.16, 95 %CI: 1.12-1.20), and musculoskeletal (HR=1.07, 95 %CI: 1.01-1.13) comorbidity had an increased fall risk compared to those with unspecific comorbidity. The highest risk of falls with fractures or head trauma was found in older adults displaying a complex or neuropsychiatric disease pattern, respectively. Higher estimates emerged in males and those aged <80 years. CONCLUSIONS: Evaluating comorbidity patterns in older AF patients could help stratify the risk of falls in this population and support targeted preventive interventions.
Trevisan et al. (Fri,) conducted a cohort in Atrial fibrillation (n=203,042). Specific comorbidity patterns (e.g., complex) vs. Unspecific comorbidity pattern was evaluated on Any fall requiring medical attention (HR 1.63, 95% CI 1.56-1.70). Complex comorbidity patterns in older adults with atrial fibrillation increased the 3-year risk of injurious falls compared to unspecific comorbidity patterns (HR 1.63; 95% CI 1.56-1.70).