Predictors of Falls in Community Dwelling Ambulatory Stroke Survivors

Research Objectives: To investigate depression, sleep, and physical activity as predictors of falls in community dwelling stroke survivors.

Design: Retrospective survey from a national cohort of community dwelling stroke survivors

Setting: Data set from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) health-related telephone survey, gathering geographically proportional data across the United States. This is the most recent dataset available.

Participants: 13,179 community dwelling stroke survivors

Interventions: Presence or absence of depressive disorder; presence or absence of sleep deficit (under 7 hours per 24 hour period); presence or absence of regular physical activity

Main Outcome Measures: Survey questions: "In the past 12 months, how many times have you fallen?"; "Were you ever told you that you had a depressive disorder, including depression, major depression, dysthymia, or minor depression"; "Do you get 7 or more hours of sleep in a 24-hour period"; and "In the past month have you participated in regular physical activities or exercises such as ...".

Results: Data were obtained from the Centers for Disease Control and Prevention. Descriptive statistics and chi-square analyses were applied. Stroke survivors were significantly more likely to have sustained a fall in the previous 12 months compared to those who had not had a stroke (OR = 2.3, 95% CI 2.2-2.4, p < 0.001). Stroke survivors who engaged in physical activity were less likely to sustain a fall (OR = 0.94, 95% CI 0.93-0.95, p < 0.001). Stroke survivors with a depressive disorder were more likely to fall (OR = 2.6, 95% CI 2.4-2.8, p < 0.001), and stroke survivors that averaged less than 7+ hours of sleep in a 24-hour period were more likely to fall (OR = 1.5, 95% CI 1.4-1.6, p< 0.001).

Conclusions: Inadequate sleep and physical activity, as well as presence of depressive disorders, were found to be predictors of falls in community dwelling stroke survivors. Post-stroke rehabilitation programs should address depressive disorders, physical activity, and sleep. Optimizing mental health management and supporting regular engagement in physical activity and sleep may decrease fall risk.

Author(s) Disclosures: None