Incidence of Falls Is Common in Older Adults with Newly Diagnosed MM

Conference Correspondent - TON - ASH 2015 - Multiple Myeloma

Multiple myeloma (MM) is disproportionately prevalent in older adults. The prognosis for these patients is influenced by a number of factors, including comorbidities and dependence in daily activities. Here, falls are postulated as another factor that may be associated by poorer outcomes among older adults with MM. This study sought to determine the prevalence of falls in a cohort of older adults with newly diagnosed MM and examine associations between falls and functional status, comorbidities, and self-reported health.

National epidemiologic data and self-reported data from the Medicare Health Outcomes Survey were used to identify patients with a diagnosis of MM who experienced at least 1 fall during the study period. Associations between falls and patient-reported data on function, comorbidities, and self-rated health were examined using standard statistical methods for this type of analysis. Researchers identified 1327 unique patients, of whom 376 completed their baseline Medicare Health Outcomes Survey within 1 year of diagnosis. Of these, 190 provided responses to the survey question regarding falls and are included in this analysis. Patients’ median age was 77 years; 50% were male.

Over one-quarter (25.2%) of patients reported a fall within the prior 12 months. In terms of comorbidities, among patients who reported 2 or more weeks of depression in the past year, 41.4% of patients reported a fall, compared with only 20.1% of those who did not report depression (P = .004). Patients who reported a fall were also more likely to report a history of congestive heart failure (22.7% fallers vs 7.9% nonfallers; P = .012). Fallers were more likely to report limitations in moderate activities (81.2% vs 62.1%; P = .015) and in climbing several flights of stairs (89.1% vs 64.9%; P = .001). Compared with nonfallers, fallers reported more days in the past 30 days when their physical health was not good (15.8 vs 10.0 days; P = .024), more days in the past 30 days when their mental health was not good (10.7 days vs 4.1 days; P = .002), and more days in the past 30 days when their health interfered with their daily activities (14.3 vs 7.0 days; P = .001). The median overall survival among fallers was 25.0 months versus 52.0 months among nonfallers.

The researchers concluded that falls are relatively common in older adults with newly diagnosed MM, and are associated with more limited activity, depression, and congestive heart failure. Additional studies are needed to elucidate factors that predict falls in order to proactively develop target interventions aimed at preventing falls, especially among high-risk patients with MM.

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Last modified: December 8, 2015