Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

The associations of multimorbidity with fall- and fracture-related hospitalisations in middle-aged adults: The Busselton Healthy Ageing Study (#392)

Mark Hoey 1 , Kevin Murray 2 , Chrianna Bharat 2 , Robert Eikelboom 3 4 , Kun (Kathy) Zhu 5 6 , Michael Hunter 2 7
  1. Western Australia Country Health Service, Busselton, WA, Australia
  2. School of Population and Global Health, University of Western Australia, Perth, WA, Australia
  3. Ear Science Institute Australia, Perth, WA, Australia
  4. Centre for Ear Science, Medical School, The University of Western Australia, Perth, WA, Australia
  5. Medical School, University of Western Australia, Perth, WA, Australia
  6. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
  7. Busselton Population Medical Research Institute, Busselton, WA, Australia

Although multimorbidity is recognised as a risk factor for falls and fractures, most studies are retrospective or cross-sectional, and few have explored the relationships between co-occurring morbidities. In 5011 participants of the Busselton Healthy Ageing Study aged 46-70 years at baseline, we evaluated the associations of multimorbidity count and patterns with incident fall- and fracture-related hospitalisations.

Twenty-one morbidities were assessed at baseline through objective measures and a self-reported questionnaire and four classes with distinct multimorbidity profiles were identified: relatively healthy, predominantly respiratory, predominantly cardiometabolic, and mental health/musculoskeletal. Fall- and fracture-related hospitalisations were captured through the Western Australian Data Linkage System from baseline visit (2010-2015) until the end of follow-up (31st December 2020). Associations were examined using Cox regression adjusting for sex, baseline age and lifestyle factors, and prior falls/fracture.

The mean number of chronic conditions at baseline was 2.8 (SD 1.8). During the follow-up incident fall- and fracture-related hospitalisations were recorded in 183 (3.6%) and 200 (3.9%) participants, respectively. A one-unit increase in multimorbidity count was associated with a 16% (95% CI: 7.5-24%) increased risk of fall-related hospitalisations. The relationship between multimorbidity count and fracture-related hospitalisations was non-linear with the risk increased exponentially for having 9 morbidities and above (9 vs 0 chronic conditions: HR 2.13 [95% CI: 1.12-4.06]). Compared with the “relatively healthy” class, multimorbidity classes with a cardiometabolic or mental health/musculoskeletal predominance were associated with an increased risk of fall-related hospitalisations (HR 2.73 [1.69-4.40] and 1.75 [1.21-2.55], respectively). For fracture-related hospitalisations, an elevated risk was observed for the “predominantly cardiometabolic” class (HR 1.71 [0.99-2.94]), albeit with limited precision.

In middle-aged adults we showed that multimorbidity count as well as certain patterns were associated with higher risk for fall- and fracture-related hospitalisations, suggesting that co-occurring morbidities should be considered when assessing a patient’s risks of falls and fractures.