A study of around 5,000 older men has shown that experiencing stressful life events - such as the death of a loved one, or being mired in serious financial problems - significantly raised risk of falling.
Researchers at the VA Medical Center in Minneapolis conducted a study of 4,981 community-dwelling men over the age of 65, who were enrolled in the Osteoporotic Fractures in Men (MrOS) study in six locations spread across the US. These men returned for a second visit and answered questions on stressful life events in the prior year. Finally, they also self-reported complete data on falls for one year after the second visit.
During the second visit, participants were asked about their marital status - and if widowed, their spouse's date of death. They were also asked to report the occurrence of any of the following stressful life events: serious illness or accident of wife/partner; death of other close relative or close friend; separation from child, close friend, or other relative on whom the participant depended on for help; loss of a pet; having to give up an important hobby or interest; being mired in serious financial troubles; move or change in residence.
Following the second visit, the participants were contacted every four months for one year regarding falls or fractures. Any fractures were confirmed by central review of radiography reports. Overall response rates exceeded 99%.
Among the men with complete stressful life event and falls data, nearly 28% fell - while nearly 15% fell multiple times during the year after visit two. Among men who reported stressful life events, falls occurred in nearly 30% of cases where one type of stressful event had been reported; 35% of cases with two types of stressful events, and nearly 40% of cases where three or more types of stressful life events were reported.
Overall, any stressful life event was associated with a 41% increase in risk of fall, and a nearly two-fold increase in risk for multiple falls in the following year. The study authors did not notice any statistically significant increase of risk for fractures.
This appears to be the first study to examine the association between stressful life events and the risk of falls. It provides strong evidence supporting stressful life events as a risk factor for falls. However, the underlying mechanism connecting stressful life events to falls still remains unclear.
One possible explanation is that stressful events cause stress hormones to be released, leading to falls and other adverse health events. It may also be that inflammation - a potential indicator of physical stress - could lead to a loss of muscle mass and impaired physical function. Or perhaps sudden emotions, triggered by a stressful event, could impact balance or visual attention, leading to a fall.
Further studies are needed to confirm these findings and to understand the mechanism underlying this association - and to answer the question whether clinical screening of older men with recent stressful life events can reduce the incidence of falls.
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