A prospective study of the incidence of falls in patients with advanced cancer

The association between aging and falls risk, and the morbidity and mortality resulting from falls in older persons, is well documented. Results from a small number of studies of patients with cancer in inpatient settings suggest that patients with advanced cancer may be at high risk of falling. We present preliminary results pertaining to the incidence of falls in patients with advanced cancer from an ongoing study of risk factors for falls.

To measure incidence of falls in patients with advanced cancer receiving palliative care, and to test the hypothesis that patients aged ≥65 years are at greater risk of falling than those aged <65 years.

Ambulant patients with cancer admitted to palliative care services were recruited. Demographic details were ascertained by patient interview and routine record review. Participants were followed-up by weekly telephone calls for up to six months.

Follow-up has been completed for 119 patients; mean age was 66.91 (±12.86) years and 53.8% were male. Sixty-two participants (52.1%) fell during follow-up. The median time to fall for participants aged <65 and ≥65 years was 85 days (95% confidence interval [CI] 51.54-118.46) and 80 days (95% CI 44.07-115.93), respectively (χ(2)=0.034, P=0.85). The incidence density of falls was 2770 per 1000 person-years.

One in two patients with advanced cancer fell during follow-up of up to six months, regardless of age. There is a need to investigate the sequelae of falls in patients with cancer, to ascertain the risk factors, and in particular, the modifiable risk factors in this population.