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Stressful events linked to fall risk for older men

By Kathleen Raven

NEW YORK (Reuters Health) - Loss of a loved one, serious financial trouble and other major stressful life events could set older men up for a fall, researchers say.

In a new study, men aged 65 and older who experienced stressful events were more likely than men who didn't to fall during the subsequent year, and multiple stressful events raised men's chances of taking a tumble even further.

Once researchers adjusted for other factors, however, stressful events did not increase the men's risk of breaking a bone.

One in three adults over age 65 falls each year in the U.S., according to the Centers for Disease Control and Prevention. Past research has shown links between risk of falling and a person's physical activity, medications, symptoms of depression and diseases such as Parkinson's or diabetes.

The current male-only study took those factors and others into account, as well as the strength of the men's social networks and their involvement in activities.

"I thought the increased risk of falling would be explained away by frailty or medication, for example," said lead author Dr. Howard Fink, an internist at the Veterans Affairs Medical Center in Minneapolis.

Instead, Fink's team saw a clear link between increased stress and fall risk. This means "stressful life events may have particularly direct health consequences to the person going through the event," Fink told Reuters Health.

And a lack of social support and connections made things worse: the lower a participant scored with regard to social networks and involvement, the higher his risk of falling. Fink said this secondary finding needs further investigation.

For the study, he and his team gathered data from 4,981 men previously enrolled in a national study designed to measure osteoporotic bone fractures. Nearly all of the men lived outside of nursing homes. Between 2005 and 2006, the participants were asked to recall stressful events during the previous year, and were then followed for the next year to collect data on falls.

Among the stressful life events the researchers considered were the death of a spouse, partner, child, friend or pet, as well as separation from a relative, change of residence, serious financial trouble, serious accidents or illnesses and loss of the ability to pursue a hobby.

About 6 in 10 of the men had experienced at least one such event in the previous year.

Fink's team found that overall, men's risk of falling was 33 percent higher if they had experienced a stressful event compared to the men who had not. And men with multiple stressful events were 68 percent more likely to fall than men with none.

Of the men with just one event, 30 percent fell during the follow-up year, while 40 percent of men with three or more events fell, according to findings published in Age and Ageing.

The authors did not have data, such as blood work, that might have shed light on how stress was affecting the men physically. But they point to past studies suggesting that stress hormones and inflammation might play a role, for instance by causing muscle loss.

Lingering emotional reactions to stressful events, such as lack of sleep, distraction and a failure to take care of oneself could also contribute to the likelihood of falling, they write.

"A stressful event may put a person at a health risk by bringing on overall physical weakness caused by inflammatory processes or a lack of sleep," said Ivan Bautmans who heads the gerontology department at Vrije Universiteit Brussel in Belgium.

Bautmans, who was not involved with the study, stressed the important link between falls and an increased general concern over an older adult's independence.

"As patients age, the main aim of a geriatrician is to help them maintain their independence," said Bautmans.

For families with older adults who are experiencing a lot of stress, it is important to offer support, Bautmans told Reuters Health.

"When a person has problems, we may think of leaving them alone because we don't want to bother them, but, conversely, we need to visit them," he said.

"Falling is still a very random event," he said. "But this is still an important piece of the puzzle that we are all working together on."

SOURCE: http://bit.ly/15GlbwW Age and Ageing, online September 3, 2013.

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