Abstract: FR-PO923

Kidney Function Is Not an Independent Predictor of Falls among Community-Dwelling Older Adults

Session Information

  • Geriatric Nephrology
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

  • 901 Geriatric Nephrology

Authors

  • Canney, Mark, Trinity College Dublin, Dublin, Ireland
  • Carey, Daniel, Trinity College Dublin, Dublin, Ireland
  • Kenny, Rose Anne M., Trinity College Dublin, Dublin, Ireland
  • Little, Mark Alan, Trinity College Dublin, Dublin, Ireland
  • O'Seaghdha, Conall M., Beaumont Hospital, Dublin, Ireland
Background

While several studies have identified a link between chronic kidney disease and markers of frailty in older age, it is largely unknown if this association translates into meaningful outcomes such as a greater risk of falls. We sought to examine the relationship between kidney function and falls in a large representative cohort of older adults.

Methods

Prospective analysis of 5060 participants from the first 3 waves (2009-2015) of The Irish Longitudinal Study on Ageing, a nationally representative sample of community-dwelling adults aged ≥50 years. All participants had estimated glomerular filtration rate (eGFR) calculated from cystatin C at wave 1. Data regarding falls (any fall in the last year or between waves) were captured via a computer-assisted personal interview at each wave. We used mixed effects logistic regression to examine the association between eGFR (≥90 [reference], 60-89, <60mL/min/1.73m2) and reporting a fall. Models were adjusted for age, sex, frailty (pre-frail/frail versus robust), diabetes, cardiovascular disease, pulse pressure, polypharmacy and chronic health conditions. Each covariate was modelled as a main effect and as a time*covariate interaction. An inverse probability weight was applied to all estimates to account for differential non-response and attrition.

Results

Mean (standard deviation) age of participants was 62.8 (9.1) years, 46% were male and median (interquartile range) eGFR was 80 (67-93) mL/min/1.73m2. After adjusting for age and sex, participants with eGFR <60mL/min/1.73m2 had a 5.0% (95% confidence interval 1.3 to 8.6%) increased probability of a fall versus the reference group (eGFR ≥90mL/min/1.73m2). This association was attenuated in the extended model (2.6% increased probability [-1.1 to 6.2%]). Results did not vary by age (over or under 65) or sex. The time*eGFR interaction was not statistically significant after adjusting for age and sex (p=0.65). Frailty and the number of chronic conditions were both independent predictors of falls in the multivariable model.

Conclusion

In this large prospective study of older community-based adults, kidney function was not found to be an independent predictor of falls. Our data suggest that, in the general population of older individuals, frailty status and comorbidity burden are more important predictors of falls than kidney function alone.

Funding

  • Government Support - Non-U.S.