Kidney function and other factors and their association with falls : The screening for CKD among older people across Europe (SCOPE) study

Sabine Britting, Rada Artzi-Medvedik, Paolo Fabbietti, Lisanne Tap, Francesco Mattace-Raso, Andrea Corsonello, Fabrizia Lattanzio, Johan Ärnlöv, Axel C Carlsson, Regina Roller-Wirnsberger, Gerhard Wirnsberger, Tomasz Kostka, Agnieszka Guligowska, Francesc Formiga, Rafael Moreno-Gonzalez, Pedro Gil, Sara Lainez Martinez, Robert Kob, Itshak Melzer, Ellen Freiberger, SCOPE investigators, Fabrizia Lattanzio, Andrea Corsonello, Silvia Bustacchini, Silvia Bolognini, Paola D'Ascoli, Raffaella Moresi, Giuseppina Di Stefano, Cinzia Giammarchi, Anna Rita Bonfigli, Roberta Galeazzi, Federica Lenci, Stefano Della Bella, Enrico Bordoni, Mauro Provinciali, Robertina Giacconi, Cinzia Giuli, Demetrio Postacchini, Sabrina Garasto, Annalisa Cozza, Francesco Guarasci, Sonia D'Alia, Romano Firmani, Moreno Nacciariti, Mirko Di Rosa, Paolo Fabbietti, Sabine Britting, Rada Artzi-Medvedik, Paolo Fabbietti, Lisanne Tap, Francesco Mattace-Raso, Andrea Corsonello, Fabrizia Lattanzio, Johan Ärnlöv, Axel C Carlsson, Regina Roller-Wirnsberger, Gerhard Wirnsberger, Tomasz Kostka, Agnieszka Guligowska, Francesc Formiga, Rafael Moreno-Gonzalez, Pedro Gil, Sara Lainez Martinez, Robert Kob, Itshak Melzer, Ellen Freiberger, SCOPE investigators, Fabrizia Lattanzio, Andrea Corsonello, Silvia Bustacchini, Silvia Bolognini, Paola D'Ascoli, Raffaella Moresi, Giuseppina Di Stefano, Cinzia Giammarchi, Anna Rita Bonfigli, Roberta Galeazzi, Federica Lenci, Stefano Della Bella, Enrico Bordoni, Mauro Provinciali, Robertina Giacconi, Cinzia Giuli, Demetrio Postacchini, Sabrina Garasto, Annalisa Cozza, Francesco Guarasci, Sonia D'Alia, Romano Firmani, Moreno Nacciariti, Mirko Di Rosa, Paolo Fabbietti

Abstract

Background: Reduced kidney function has become a major public health concern, especially among older people, as Chronic Kidney Disease (CKD) is associated with increased risk of end stage renal disease and mortality. Falls are a serious negative health outcome in older persons with one third of people aged 65 years experiencing a fall per year and increasing fall rates with increasing age. The impact of CKD on falls in older community-dwelling persons is not well investigated. Additionally, lower urinary tract symptoms (LUTS) may also increase the risk of falls. Therefore, our aim was to investigate the impact of CKD and LUTS on falls as well as on injurious falls.

Methods: The SCOPE study is an observational, multinational, multicenter, prospective cohort study involving community-dwelling older persons aged 75 years and more recruited from August 2016 to March 2018 in seven European countries. The main outcomes of the present study were any falls and any injurious falls during the 12 months before enrolment. The cross-sectional association of estimated glomerular filtration rate (eGFR) and LUTS with study outcomes was investigated by logistic regression analysis adjusted for baseline characteristics of enrolled subjects.

Results: Our series consisted of 2256 SCOPE participants (median age = 79.5 years, 55.7% female). Of them, 746 participants experienced a fall and 484 reported an injurious fall in the 12 months prior to baseline assessment. CKD was not significantly associated with falls (OR = 0.95, 95%CI = 0.79-1.14 for eGFR< 60; OR = 1.02, 95%CI = 0.81-1.28 for eGFR< 45; OR = 1.08, 95%CI = 0.74-1.57 for eGFR< 30) or injurious falls (OR = 0.91, 95%CI = 0.67-1.24 for eGFR< 60; OR = 0.93, 95%CI = 0.63-1.37 for eGFR< 45; OR = 1.19, 95%CI = 0.62-2.29 for eGFR< 30). LUTS were found significantly associated with both falls (OR = 1.56, 95%CI = 1.29-1.89) and injurious falls (OR = 1.58, 95%CI = 1.14-2.19), and such associations were confirmed in all multivariable models.

Conclusions: Cross-sectional data suggest that CKD may not be associated with history of falls or injurious falls, whereas LUTS is significantly associated with the outcomes.

Trial registration: This study was registered on 25th February 2016 at clinicaltrials.gov ( NCT02691546 ).

Keywords: Falls; Fear of falling; Injurious falls; Kidney function; Older people; Urinary incontinence.

Conflict of interest statement

The authors declare no competing of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Patients were requested to sign a written informed consent before entering the study.

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