OBJECTIVES Falls are associated with several negative outcomes. Early identification of those who are at risk of falling is of importance in geriatrics, and comprehensive geriatric assessment (CGA) seems to be promising in this regard. Therefore, the present study investigated whether the multidimensional prognostic index (MPI), based on a standard CGA, is associated with falls in the Osteoarthritis Initiative (OAI). DESIGN Longitudinal, 8 years of follow-up. SETTING AND PARTICIPANTS Community-dwelling older people (≥65 years of age) with knee osteoarthritis or at high risk for this condition. METHODS A standardized CGA including information on functional, nutritional, mood, comorbidities, medications, quality of life, and cohabitation status was used to calculate a modified version of the MPI, categorized as MPI-1 (low), MPI-2 (moderate), and MPI-3 (high risk). Falls were self-reported and recurrent fallers were defined as ≥2 in the previous year. Logistic regression was carried out and results are reported as odds ratio (ORs) with their 95% confidence intervals (CIs). RESULTS The final sample consisted of 885 older adults (mean age 71.3 years, female = 54.6%). Recurrent fallers showed a significant higher MPI than their counterparts (0.46 ± 0.17 vs 0.38 ± 0.16; P < .001). Compared with those in MPI-1 category, participants in MPI-2 (OR 2.13; 95% CI 1.53‒2.94; P < .001) and in MPI-3 (OR 5.98; 95% CI 3.29-10.86; P < .001) reported a significant higher risk of recurrent falls over the 8-years of follow-up. Similar results were evident when using an increase in 0.1 points in the MPI or risk of falls after 1 year. CONCLUSIONS AND IMPLICATIONS Higher MPI values at baseline were associated with an increased risk of recurrent falls, suggesting the importance of CGA in predicting falls in older people.

中文翻译：

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多维预后指数预测老年人跌倒：骨关节炎倡议的 8 年纵向队列研究

目标 跌倒与多种负面结果相关。早期识别有跌倒风险的人在老年医学中很重要，综合老年评估 (CGA) 在这方面似乎很有希望。因此，本研究调查了基于标准 CGA 的多维预后指数 (MPI) 是否与骨关节炎倡议 (OAI) 的跌倒相关。设计 纵向，8 年随访。地点和参与者 患有膝骨关节炎或患有这种疾病的高风险的社区老年人（≥65 岁）。方法 包括功能、营养、情绪、合并症、药物、生活质量和同居状态信息的标准化 CGA 用于计算 MPI 的修改版本，分类为 MPI-1（低）、MPI-2（中） , 和 MPI-3（高风险）。跌倒是自我报告的，反复跌倒定义为前一年≥2。进行逻辑回归并将结果报告为优势比 (OR) 及其 95% 置信区间 (CI)。结果 最终样本包括 885 名老年人（平均年龄 71.3 岁，女性 = 54.6%）。经常性跌倒者的 MPI 显着高于其同行（0.46 ± 0.17 vs 0.38 ± 0.16；P < .001）。与 MPI-1 类别的参与者相比，MPI-2（OR 2.13；95% CI 1.53-2.94；P < .001）和 MPI-3（OR 5.98；95% CI 3.29-10.86；P < .001）的参与者) 报告了在 8 年的随访中反复跌倒的风险显着增加。当 MPI 增加 0.1 个点或 1 年后跌倒的风险时，类似的结果很明显。