Injurious Falls before, during, and after Stroke Diagnosis: A Population-based Study

Area of Science:

• Neurology
• Gerontology
• Public Health

Background:

• Falls are a common concern for older adults.
• Stroke survivors are at increased risk of falls.
• Understanding fall patterns and risk factors around stroke is crucial for patient safety.

Purpose of the Study:

• To investigate the incidence of injurious falls in the periods before, during, and after stroke.
• To identify specific risk factors associated with falls in individuals with stroke, both pre- and post-diagnosis.

Main Methods:

• A prospective cohort study utilizing the Swedish Twin Registry.
• 4431 participants with incident stroke and 4431 matched stroke-free controls were followed for 21 years.
• Data on stroke and injurious falls were extracted from medical records and analyzed using conditional Poisson regression and GEE models.

Main Results:

• Injurious fall incidence was significantly higher in the stroke group starting 3 years pre-stroke, peaking at diagnosis, and remaining elevated for 4 years post-stroke.
• Pre-stroke fall risk factors included smoking, heavy drinking, and overweight.
• Post-stroke fall risk factors included being single and having heart disease.

Conclusions:

• The incidence of injurious falls is substantially elevated in individuals with stroke, beginning years before diagnosis and persisting into the post-stroke period.
• Distinct risk factors for falls exist in the pre-stroke and post-stroke phases.
• Implementing preventive strategies is recommended to mitigate both stroke and fall-related risks.