Biology of Falls: Preliminary Cohort Study Suggesting a Possible Role for Oxidative Stress

Biological underpinnings of falls in older adults are not well established.

To examine the validity of selected oxidative stress and inflammatory biomarkers for predicting incident falls in community-dwelling older adults.

Prospective cohort study.

266 non-demented and ambulatory community-dwelling older adults (mean age 78 years, 55% women).

Oxidative stress (malondialdehyde) and inflammatory (interleukin-6 [IL-6]) biomarkers were selected based on associations with fall risk factors, and values were log-transformed to account for non-normal distributions.

Over a mean follow-up of 20.5 ± 10.1 months, 119 participants fell. In Cox proportional hazards models, each one standard deviation increase in baseline log-malondialdehyde levels predicted incident falls (Hazard ratio (HR) adjusted for age, gender, education, comorbidity count, medications, log-IL-6 levels, prior falls, depressive symptoms, cognitive status, gait velocity, and balance 1.53, 95% CI 1.11-2.16). Log-IL-6 levels were not associated with falls. Participants in the highest log-malondialdehyde quartile at baseline had increased risk for incident falls than those in the lowest quartile (HR 2.47, 95% CI 1.41-4.34).

Oxidative stress predicted falls in a community-based cohort, and should be further examined as a fall risk biomarker as well as a potential target to prevent falls.