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Emotional stress increased risk for falls in older men

A recent history of one or more stressful life events increased the risk for future falls in older men, according to recent study results published in Age and Ageing.

"To my knowledge, this is the first prospective study to examine the independent association between stressful life events and the risk of falls in community-dwelling older men," study researcher Howard A. Fink, MD, MPH, a staff physician at the VA Medical Center in Minneapolis, said in a press release. "We believe it provides the strongest evidence to date supporting stressful life events as a risk factor for falls. However, the mechanism connecting stressful life events to falls is uncertain."

Fink and colleagues analyzed data on 5,152 men aged at least 65 years who were enrolled in the Osteoporotic Fractures in Men study. The study participants reported on stressful life events, such as death of a close friend or relative, serious accidents or illnesses of a spouse, and separation from a child, close friend or relative on whom the participant depended for help. A subgroup of 4,981 men reported complete data on incident falls and fractures during a follow-up visit 1 year later.

Among the subgroup of older men with complete data, 27.7% fell and 14.7% fell multiple times during the year before their follow-up visit. Falls occurred in 29.9% of older men with one type of stressful event, 35.5% with two types and 39.9% with three or more.

In age-adjusted analyses, any type of stressful event was associated with an increased risk for incident fall (RR=1.41; 95% CI, 1.28-1.55), and the risk was nearly double for multiple falls (RR=1.87; 95% CI, 1.61-2.18).

The relationship between stressful life events and fractures was not statistically significant after controlling for bone mineral density, sustaining a fracture after age 50 years, Parkinson's disease, stroke and instrumental activities of daily living impairment, the researchers said.

Although the exact reasons for the association between stressful life events and incident falls is unknown, the researchers said the relationship might be explained by a neurohormonal response to stress, causing physiological dysregulation and eventually leading to adverse health events such as falls. Another possible explanation is that inflammation as a result of experiencing emotional stress may lead to loss of muscle mass and increased physical impairment. Balance also may be affected by sudden emotions triggered by stressful life events.

"Further studies are needed to confirm our findings and to investigate the mechanism underlying this association," Fink said. "Additional studies may explore whether clinical screening of older men with recent stressful life events for fall reduction interventions will reduce falls."

Disclosure: The researchers report no relevant financial disclosures.