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Table 3 Associated between fall incidence and its risk factors ( univariate and multiple Cox proportional regression models)

From: Low physical activity and depression are the prominent predictive factors for falling in older adults: the Birjand Longitudinal Aging Study (BLAS)

Variables

Hazard ratio

95% CI HR

P-Value

A univariate Cox proportional regression model

Age (Each year increase)

1.02

0.99–1.05

0.124

Sex (Male/Female)

0.28

0.16–0.48

< 0.001

Body mass index (kg/m2)

Ideal body (18.5–25)

Reference group

Low body (≤ 18.5)

1.04

0.31–3.52

0.938

Overweight (25-29.9)

1.41

0.81–2.44

0.222

Obesity (≥ 30)

2.07

1.15–3.70

0.014

Low grip strength (kg/cm2) (Female < 16) & (Male < 27)

1.60

1.03–2.47

0.035

Low gait speed (m/s), (≥ 0.8)

3.91

1.58–9.68

< 0.001

calf circumference (Each centimeter increase)

1.02

0.99–1.06

0.102

Mid-arm circumference (Each centimeter increase)

1.06

1.00–1.12

0.028

Waist circumference (Each centimeter increase)

1.02

1.00–1.04

0.010

Urinary incontinence (Yes/No)

1.35

0.73–2.49

0.339

Cancer (Yes/No)

2.06

0.65–6.54

0.219

Hearing loss (Yes/No)

1.23

0.63–2.39

0.531

Visual impairment (Yes/No)

1.19

0.73–1.92

0.468

Diabetes mellitus (Yes/No)

1.15

0.71–1.86

0.559

Thyroid (Yes/No)

1.36

0.59–3.14

0.463

Chronic obstructive pulmonary disease (Yes/no)

1.01

0.14–7.31

0.987

Hypertension (Yes/No)

1.02

0.65–1.59

0.915

Congestive heart failure (Yes/No)

1.31

0.69–2.49

0.395

Cerebrovascular accident (Yes/No)

1.63

0.71–3.75

0.248

Acute Myocardial Infarction (Yes/No)

0.86

0.31–2.36

0.778

Pain (Yes/No)

1.56

0.86–2.82

0.142

Osteoporosis (Yes/No)

1.77

0.99–3.15

0.053

Osteoarthritis (Yes/No)

1.93

1.20–3.13

< 0.001

Cognitive function (MMSE)

Normal cognitive

Reference group

Mild cognitive

1.06

0.64–1.77

0.798

Dementia

1.56

0.80–3.02

0.185

Depression (PHQ-9 score)

Normal mood (0–5)

Reference group

Mild depression (5–9)

1.17

0.65–2.10

0.586

Moderate depression (10–14)

2.05

1.11–3.76

0.020

Moderately-severe depression (15–19)

4.46

2.24–8.90

< 0.001

Severe Depression (20–27)

5.31

2.06–13.67

< 0.001

Sleep Quality

Very good

Reference group

Relatively good

1.10

0.44–2.77

0.831

Relatively poor

1.37

0.51–3.68

0.526

Very poor

4.08

1.24–13.41

0.020

Physical activity (Active/ Totally inactive)

0.44

0.27–0.70

< 0.001

Impair balance (TUG), (> 12 s)

2.29

1.47–3.577

< 0.001

SPPB (Each score increase)

0.57

0.40–0.80

< 0.001

Smoking (Yes/No)

0.41

0.13–1.32

0.139

Polypharmacy (Yes/No)

1.73

1.03–2.91

0.036

Nutrition status (MNA)

Well nutrition (≥ 24)

Reference group

At risk of malnutrition (17–24)

1.79

1.13–2.81

0.011

Malnutrition (≤ 17)

2.82

0.68–11.61

0.151

ADL (Barthel’s index), (Independent/Dependent)

0.57

0.36 − 0.89

0.013

IADL (Lawton IADL), (Independent/Dependent)

0.86

0.78–0.95

< 0.001

Marital status (Married/ No married)

0.54

0.33–0.88

0.014

Job status

Retire

Reference group

Employed

0.29

0.06–1.24

0.096

Housekeeper

2.09

1.27–3.44

< 0.001

Unemployed

1.06

0.31–3.55

0.922

Education years (Each year increase)

0.97

0.93–1.02

0.290

Living arrangement (Live alone/ live with)

1.18

0.62–2.23

0.603

Wealth Index quintile

First (Poorest)

Reference group

Second

0.85

0.43–1.68

0.656

Third

0.97

0.50–1.86

0.928

Fourth

0.48

0.22–1.06

0.071

Fifth (Richest)

0.94

0.49–1.82

0.872

Multiple Cox proportional regression model

Sex (Male/Female)

0.37

0.21–0.64

< 0.001

Depression (PHQ-9 score)

Normal mood (0–5)

Reference group

Mild depression (5–9)

0.81

0.44–1.47

0.492

Moderate depression (10–14)

1.31

0.70–2.45

0.382

Moderately-severe depression (15–19)

2.97

1.47–6.01

< 0.001

Severe Depression (20–27)

3.26

1.24–8.54

0.016

Physical activity (Active/ Totally inactive)

0.59

0.36–0.96

0.034

Impair balance (TUG), (> 12 s)

1.73

1.10–2.72

0.017

  1. h = Hazard ratio, CI = Confidence Interval, MMSE = Mini-Mental State Examination, PHQ-9 = Patient Health Questionnaire-9, TUG = Timed up and go, SPPB = Short Performance Physical Battery, MNA = Mini Nutritional Assessment, ADL = Activities of Daily Living, IADL = Instrumental Activities of Daily Living. Significant variables were bolded
  2. MMSE scoring:
  3. • Normal cognitive (Illiterate ≥ 19, Primary school ≥ 24, High school ≥ 27, Academic ≥ 28)
  4. • Mild cognitive impairment (Illiterate = ≥ 14 MMSE score < 19, Primary school = ≥ 20 MMSE score < 24, High school = 24 ≥ MMSE score < 27, Academic = ≥ 25 MMSE score < 28)
  5. • Dementia (Illiterate < 14, Primary school < 20, High school < 24, Academic < 25)