90 Demographics and Characteristics of Patients with Recurrent Falls Attending Tertiary Hospital Outpatients Department

Abstract Background Falls are a common cause of morbidity and mortality in older adults, with most being caused by identifiable risk factors. This study aimed to assess demographics and clinical characteristics of patients who had recurrent falls attending the medicine for the older person (MFTOP) outpatient department at a tertiary centre. Methods Retrospective analysis of patients seen at MFTOP OPD between January 2018 and December 2018. Data were obtained from clinical notes. Age, gender, blood pressure, cognitive tests, blood tests, diagnoses and medications that could contribute to falls were recorded. Results 100 patients were reviewed. 60% were female (60). Mean and median ages were 83. Causes of falls included; gait/balance disorders or weakness 36.0%, environment-related/'accident' 19.0%, alcohol 5.0%, dizziness/vertigo 5.0%, visual disorder 4.0%, confusion 4.0%, others 3.0%, drop attack 1.0%, unknown 5.0%. 18.4% (18/98) had orthostatic hypotension (OH), of which 44.4% (8/18) had low standing systolic BP <120 P=0.0205 compared to the non-OH group. Median HbA1c was 39 (30 - 83) for 80 patients 95% CI 39.5-43.4. 11.9% (11/92) had low serum sodium (<135) (95% CI 137.7-139.3). 29.0% (29/100) had impaired cognition of which 13.4% (4/29) were at risk of vitamin D deficiency P=0.5767. Other medical conditions potentially contributing to falls included; arthritis 16.0%, Parkinson’s disease 7% and incontinence 3.0%. Medications that can contribute to falls included; antihypertensive agents 67 (66.3%), tricyclic antidepressants 19 (18.8%), antianxiety agents 15 (14.9%), opiates 12 (11.9%), hypnotics/ tranquilizers 27(26.7%) and diuretics 28 (27.7%). Conclusion There is a high prevalence of co-morbidities and polypharmacy in patients with recurrent falls. Identifying modifiable causes may reduce the risk of falls in the future. Tighter glycaemic control was observed and relaxed glucose control in high-risk older adults are recommended.