About this Journal Submit a Manuscript Table of Contents
Journal of Aging Research
Volume 2013 (2013), Article ID 342650, 6 pages
http://dx.doi.org/10.1155/2013/342650
Review Article

A Growing Troubling Triad: Diabetes, Aging, and Falls

Center for Lower Extremity Ambulatory Research (CLEAR), Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA

Received 5 December 2012; Accepted 11 January 2013

Academic Editor: Neil D. Reeves

Copyright © 2013 Ryan T. Crews et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. C. A. Werner, The Older Population: 2010, in 2010 Census Briefs, United States Census Bureau, 2011.
  2. G. K. Vincent and V. A. Velkoff, THE NEXT FOUR DECADES The Older Population in the United States: 2010 to 2050, in Population Estimates and Projections, United States Census Bureau, 2010.
  3. J. A. Stevens, P. S. Corso, E. A. Finkelstein, and T. R. Miller, “The costs of fatal and non-fatal falls among older adults,” Injury Prevention, vol. 12, no. 5, pp. 290–295, 2006. View at Publisher · View at Google Scholar · View at Scopus
  4. P. Scuffham, S. Chaplin, and R. Legood, “Incidence and costs of unintentional falls in older people in the United Kingdom,” Journal of Epidemiology and Community Health, vol. 57, no. 9, pp. 740–744, 2003. View at Publisher · View at Google Scholar · View at Scopus
  5. D. Hendrie, S. E. Hall, G. Arena, and M. Legge, “Health system costs of falls of older adults in Western Australia,” Australian Health Review, vol. 28, no. 3, pp. 363–373, 2004. View at Scopus
  6. L. M. Tilling, K. Darawil, and M. Britton, “Falls as a complication of diabetes mellitus in older people,” Journal of Diabetes and Its Complications, vol. 20, no. 3, pp. 158–162, 2006. View at Publisher · View at Google Scholar · View at Scopus
  7. K. S. Kim, S. K. Kim, K. M. Sung, et al., “Management of type 2 diabetes mellitus in older adults,” Diabetes & Metabolism Journal, vol. 36, no. 5, pp. 336–344, 2012. View at Publisher · View at Google Scholar
  8. C. Macgilchrist, L. Paul, B. M. Ellis, T. E. Howe, B. Kennon, and J. Godwin, “Lower-limb risk factors for falls in people with diabetes mellitus,” Diabetic Medicine, vol. 27, no. 2, pp. 162–168, 2010. View at Publisher · View at Google Scholar · View at Scopus
  9. P. P. Oliveira, S. Maria Fachin, J. Jozatti, et al., “Comparative analysis of risk for falls in patients with and without type 2 diabetes mellitus,” Revista da Associação Médica Brasileira, vol. 58, no. 2, pp. 234–239, 2012. View at Publisher · View at Google Scholar
  10. A. V. Schwartz, T. A. Hillier, D. E. Sellmeyer et al., “Older women with diabetes have a higher risk of falls: a prospective study,” Diabetes Care, vol. 25, no. 10, pp. 1749–1754, 2002. View at Publisher · View at Google Scholar · View at Scopus
  11. K. van Acker, D. Bouhassira, D. de Bacquer et al., “Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics,” Diabetes & Metabolism, vol. 35, no. 3, pp. 206–213, 2009. View at Publisher · View at Google Scholar · View at Scopus
  12. M. J. Young, A. J. M. Boulton, A. F. Macleod, D. R. R. Williams, and P. H. Sonksen, “A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population,” Diabetologia, vol. 36, no. 2, pp. 150–154, 1993. View at Publisher · View at Google Scholar · View at Scopus
  13. S. Tesfaye, L. K. Stevens, J. M. Stephenson et al., “Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study,” Diabetologia, vol. 39, no. 11, pp. 1377–1384, 1996. View at Publisher · View at Google Scholar · View at Scopus
  14. S. Tesfaye, “Diabetic Neuropathy,” in The Foot in Diabetes, P. R. Cavanagh, A. J. M. Boulton, and G. Rayman, Eds., John Wiley & Sons, West Sussex, UK, 2006.
  15. B. Najafi, D. Horn, S. Marclay, R. T. Crews, S. Wu, and J. S. Wrobel, “Foot technology, part 1 of 2: assessing postural control and postural control strategy in diabetes patients using innovative and wearable technology,” Journal of Diabetes Science and Technology, vol. 4, no. 4, pp. 780–791, 2010. View at Scopus
  16. H. B. Menz, S. R. Lord, R. St George, and R. C. Fitzpatrick, “Walking stability and sensorimotor function in older people with diabetic peripheral neuropathy,” Archives of Physical Medicine and Rehabilitation, vol. 85, no. 2, pp. 245–252, 2004. View at Publisher · View at Google Scholar · View at Scopus
  17. B. Najafi, D. Horn, S. Marclay, R. T. Crews, S. Wu, and J. S. Wrobel, “Assessing postural control and postural control strategy in diabetes patients using innovative and wearable technology,” Journal of Diabetes Science and Technology, vol. 4, no. 4, pp. 780–791, 2010. View at Scopus
  18. A. V. Schwartz, T. A. Hillier, D. E. Sellmeyer et al., “Older women with diabetes have a higher risk of falls: a prospective study,” Diabetes Care, vol. 25, no. 10, pp. 1749–1754, 2002. View at Publisher · View at Google Scholar · View at Scopus
  19. S. I. Lin, Y. R. Chen, C. F. Liao, and C. W. Chou, “Association between sensorimotor function and forward reach in patients with diabetes,” Gait & Posture, vol. 32, no. 4, pp. 581–585, 2010. View at Publisher · View at Google Scholar · View at Scopus
  20. J. K. Richardson and E. A. Hurvitz, “Peripheral neuropathy: a true risk factor for falls,” The Journals of Gerontology A, vol. 50, no. 4, pp. M211–M215, 1995. View at Scopus
  21. E. Pijpers, I. Ferreira, R. T. de Jongh, et al., “Older individuals with diabetes have an increased risk of recurrent falls: analysis of potential mediating factors: the Longitudinal Ageing Study Amsterdam,” Age Ageing, vol. 41, no. 3, pp. 358–365, 2012. View at Publisher · View at Google Scholar
  22. J. S. Wrobel, R. T. Crews, and J. E. Connolly, “Clinical factors associated with a conservative gait pattern in older male veterans with diabetes,” Journal of Foot and Ankle Research, vol. 2, no. 1, article 11, 2009. View at Publisher · View at Google Scholar · View at Scopus
  23. M. E. Tinetti, M. Speechley, and S. F. Ginter, “Risk factors for falls among elderly persons living in the community,” The New England Journal of Medicine, vol. 319, no. 26, pp. 1701–1707, 1988. View at Scopus
  24. S. I. Lin, Y. R. Chen, C. F. Liao, and C. W. Chou, “Association between sensorimotor function and forward reach in patients with diabetes,” Gait & Posture, vol. 32, no. 4, pp. 581–585, 2010. View at Publisher · View at Google Scholar · View at Scopus
  25. P. P. Alvarenga, D. S. Pereira, and D. M. C. Anjos, “Functional mobility and executive function in elderly diabetics and non-diabetics,” Revista Brasileira de Fisioterapia, vol. 14, no. 6, pp. 491–496, 2010. View at Scopus
  26. F. B. Horak, “Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?” Age and Ageing, vol. 35, supplement 2, pp. ii7–ii11, 2006. View at Publisher · View at Google Scholar · View at Scopus
  27. S. Morrison, S. R. Colberg, H. K. Parson, et al., “Relation between risk of falling and postural sway complexity in diabetes,” Gait Posture, vol. 35, no. 4, pp. 662–668, 2012. View at Publisher · View at Google Scholar
  28. G. D. Fulk, C. J. Robinson, S. Mondal, C. M. Storey, and A. M. Hollister, “The effects of diabetes and/or peripheral neuropathy in detecting short postural perturbations in mature adults,” Journal of NeuroEngineering and Rehabilitation, vol. 7, no. 1, article 44, 2010. View at Publisher · View at Google Scholar · View at Scopus
  29. J. S. Wrobel and B. Najafi, “Foot technology, part 1 of 2: diabetic foot biomechanics and gait dysfunction,” Journal of Diabetes Science and Technology, vol. 4, no. 4, pp. 833–845, 2010. View at Scopus
  30. L. Allet, S. Armand, R. A. de Bie et al., “The gait and balance of patients with diabetes can be improved: a randomised controlled trial,” Diabetologia, vol. 53, no. 3, pp. 458–466, 2010. View at Publisher · View at Google Scholar · View at Scopus
  31. E. Nordin, R. Moe-Nilssen, A. Ramnemark, and L. Lundin-Olsson, “Changes in step-width during dual-task walking predicts falls,” Gait & Posture, vol. 32, no. 1, pp. 92–97, 2010. View at Publisher · View at Google Scholar · View at Scopus
  32. D. A. Winter, A. E. Patla, J. S. Frank, and S. E. Walt, “Biomechanical walking pattern changes in the fit and healthy elderly,” Physical Therapy, vol. 70, no. 6, pp. 340–347, 1990. View at Scopus
  33. S. M. Friedman, B. Munoz, S. K. West, G. S. Rubin, and L. P. Fried, “Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention,” Journal of the American Geriatrics Society, vol. 50, no. 8, pp. 1329–1335, 2002. View at Publisher · View at Google Scholar · View at Scopus
  34. L. Allet, S. Armand, R. A. de Bie et al., “Clinical factors associated with gait alterations in diabetic patients,” Diabetic Medicine, vol. 26, no. 10, pp. 1003–1009, 2009. View at Publisher · View at Google Scholar · View at Scopus
  35. S. G. Leveille, J. Bean, K. Bandeen-Roche, R. Jones, M. Hochberg, and J. M. Guralnik, “Musculoskeletal pain and risk for falls in older disabled women living in the community,” Journal of the American Geriatrics Society, vol. 50, no. 4, pp. 671–678, 2002. View at Publisher · View at Google Scholar · View at Scopus
  36. A. Gabell, M. A. Simons, and U. S. L. Nayak, “Falls in the healthy elderly: predisposing causes,” Ergonomics, vol. 28, no. 7, pp. 965–975, 1985. View at Scopus
  37. S. L. Krein, M. Heisler, J. D. Piette, F. Makki, and E. A. Kerr, “The effect of chronic pain on diabetes patients' self-management,” Diabetes Care, vol. 28, no. 1, pp. 65–70, 2005. View at Publisher · View at Google Scholar · View at Scopus
  38. M. J. Bair, E. J. Brizendine, R. T. Ackermann, C. Shen, K. Kroenke, and D. G. Marrero, “Prevalence of pain and association with quality of life, depression and glycaemic control in patients with diabetes,” Diabetic Medicine, vol. 27, no. 5, pp. 578–584, 2010. View at Publisher · View at Google Scholar · View at Scopus
  39. R. M. Leipzig, R. G. Cumming, and M. E. Tinetti, “Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs,” Journal of the American Geriatrics Society, vol. 47, no. 1, pp. 30–39, 1999. View at Scopus
  40. A. J. Campbell, M. J. Borrie, and G. F. Spears, “Risk factors for falls in a community-based prospective study of people 70 years and older,” Journals of Gerontology, vol. 44, no. 4, pp. M112–M117, 1989. View at Scopus
  41. H. Luukinen, K. Koski, P. Laippala, and S. L. Kivela, “Predictors for recurrent falls among the home-dwelling elderly,” Scandinavian Journal of Primary Health Care, vol. 13, no. 4, pp. 294–299, 1995. View at Scopus
  42. E. S. Huang, A. J. Karter, K. K. Danielson, E. M. Warton, and A. T. Ahmed, “The association between the number of prescription medications and incident falls in a multi-ethnic population of adult type-2 diabetes patients: the diabetes and aging study,” Journal of General Internal Medicine, vol. 25, no. 2, pp. 141–146, 2010. View at Publisher · View at Google Scholar · View at Scopus
  43. J. M. Nelson, K. Dufraux, and P. F. Cook, “The relationship between glycemic control and falls in older adults,” Journal of the American Geriatrics Society, vol. 55, no. 12, pp. 2041–2044, 2007. View at Publisher · View at Google Scholar · View at Scopus
  44. S. S. Johnston, C. Conner, M. Aagren, et al., “Association between hypoglycaemic events and fall-related fractures in Medicare-covered patients with type 2 diabetes,” Diabetes, Obesity and Metabolism, vol. 14, no. 7, pp. 634–643, 2012. View at Publisher · View at Google Scholar
  45. A. V. Schwartz, E. Vittinghoff, D. E. Sellmeyer et al., “Diabetes-related complications, glycemic control, and falls in older adults,” Diabetes Care, vol. 31, no. 3, pp. 391–396, 2008. View at Publisher · View at Google Scholar · View at Scopus
  46. J. E. Signorovitch, D. Macaulay, M. Diener, et al., “Hypoglycaemia and accident risk in people with type 2 diabetes mellitus treated with non-insulin antidiabetes drugs,” Diabetes, Obesity and Metabolism, In press. View at Publisher · View at Google Scholar
  47. D. K. Miller, L.-Y. Lily Lui, F. E. Kaiser, et al., “Reported and measured physical functioning in older inner-city diabetic African Americans,” The Journals of Gerontology A, vol. 54, no. 5, pp. M230–M236, 1999. View at Publisher · View at Google Scholar
  48. A. V. Schwartz, K. L. Margolis, D. E. Sellmeyer, et al., “Intensive glycemic control is not associated with fractures or falls in the ACCORD randomized trial,” Diabetes Care, vol. 35, no. 7, pp. 1525–1531, 2012. View at Publisher · View at Google Scholar
  49. H. B. Menz, M. E. Morris, and S. R. Lord, “Footwear characteristics and risk of indoor and outdoor falls in older people,” Gerontology, vol. 52, no. 3, pp. 174–180, 2006. View at Publisher · View at Google Scholar · View at Scopus
  50. J. L. Kelsey, E. Procter-Gray, U. S. D. T. Nguyenb, W. Li, D. P. Kiel, and M. T. Hannan, “Footwear and falls in the home among older individuals in the MOBILIZE Boston study,” Footwear Science, vol. 2, no. 3, pp. 123–129, 2010. View at Publisher · View at Google Scholar · View at Scopus
  51. S. Kumar, H. A. Ashe, L. N. Parnell, et al., “The prevalence of foot ulceration and its correlates in type 2 diabetic patients: a population-based study,” Diabetic Medicine, vol. 11, no. 5, pp. 480–484, 2009.
  52. D. J. Margolis, D. S. Malay, O. J. Hoffstad, et al., “Prevalence of diabetes, diabetic foot ulcer, and lower extremity amputation among Medicare beneficiaries, 2006 to 2008: data Points #1,” in Data Points Publication Series, Agency for Healthcare Research and Quality, Rockville, Md, USA, 2011, http://www.ncbi.nlm.nih.gov/books/NBK63602/.
  53. A. Veves, H. J. Murray, M. J. Young, and A. J. M. Boulton, “The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study,” Diabetologia, vol. 35, no. 7, pp. 660–663, 1992. View at Publisher · View at Google Scholar · View at Scopus
  54. L. A. Lavery, S. A. Vela, D. C. Lavery, and T. L. Quebedeaux, “Reducing dynamic foot pressures in high-risk diabetic subjects with foot ulcerations: a comparison of treatments,” Diabetes Care, vol. 19, no. 8, pp. 818–821, 1996. View at Scopus
  55. S. C. Wu, R. T. Crews, and D. G. Armstrong, “The pivotal role of offloading in the management of neuropathic foot ulceration,” Current Diabetes Reports, vol. 5, no. 6, pp. 423–429, 2005. View at Publisher · View at Google Scholar · View at Scopus
  56. A. J. M. Boulton, “Pressure and the diabetic foot: clinical science and offloading techniques,” The American Journal of Surgery, vol. 187, no. 5, supplement 1, pp. S17–S24, 2004. View at Publisher · View at Google Scholar · View at Scopus
  57. P. R. Cavanagh, B. A. Lipsky, A. W. Bradbury, and G. Botek, “Treatment for diabetic foot ulcers,” The Lancet, vol. 366, no. 9498, pp. 1725–1735, 2005. View at Publisher · View at Google Scholar · View at Scopus
  58. R. van Deursen, “Footwear for the neuropathic patient: offloading and stability,” Diabetes/Metabolism Research and Reviews, vol. 24, no. supplement 1, pp. S96–S100, 2008. View at Publisher · View at Google Scholar · View at Scopus
  59. L. A. Lavery, J. G. Fleishli, T. J. Laughlin, S. A. Vela, D. C. Lavery, and D. G. Armstrong, “Is postural instability exacerbated by off-loading devices in high risk diabetics with foot ulcers?” Ostomy Wound Management, vol. 44, no. 1, pp. 26–34, 1998. View at Scopus
  60. M. EI-Nahas, H. M. Gawish, M. M. Tarshoby, et al., “Effect of simulated leg length discrepancy on plantar pressure distribution in diabetic patients with neuropathic foot ulceration,” Journal of Wound Care, vol. 20, no. 10, pp. 473–477, 2011.
  61. S. R. Lord, P. N. Sambrook, C. Gilbert et al., “Postural stability, falls and fractures in the elderly: results from the Dubbo Osteoporosis Epidemiology Study,” The Medical Journal of Australia, vol. 160, no. 11, pp. 684–688, 1994. View at Scopus
  62. R. T. Crews, F. Sayeed, and B. Najafi, “Impact of strut height on offloading capacity of removable cast walkers,” Clinical Biomechanics, vol. 27, no. 7, pp. 725–730, 2012. View at Publisher · View at Google Scholar
  63. E. W. Gregg, M. M. Engelgau, and V. Narayan, “Complications of diabetes in elderly people,” British Medical Journal, vol. 325, no. 7370, pp. 916–917, 2002. View at Scopus
  64. W. Ekstrom, A. N. Al-Ani, M. Sääf, et al., “Health related quality of life, reoperation rate and function in patients with diabetes mellitus and hip fracture—a 2 year follow-up study,” Injury. In press. View at Publisher · View at Google Scholar
  65. E. S. Strotmeyer, J. A. Cauley, A. V. Schwartz et al., “Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study,” Archives of Internal Medicine, vol. 165, no. 14, pp. 1612–1617, 2005. View at Publisher · View at Google Scholar · View at Scopus
  66. J. E. Compston, N. B. Watts, R. Chapurlat, et al., “Obesity is not protective against fracture in postmenopausal women: GLOW,” The American Journal of Medicine, vol. 124, no. 11, pp. 1043–1050, 2011. View at Publisher · View at Google Scholar
  67. P. L. A. van Daele, R. P. Stolk, H. Burger et al., “Bone density in non-insulin-dependent diabetes mellitus. The Rotterdam Study,” Annals of Internal Medicine, vol. 122, no. 6, pp. 409–414, 1995. View at Scopus
  68. V. Rakic, W. A. Davis, S. A. P. Chubb, F. M. A. Islam, R. L. Prince, and T. M. E. Davis, “Bone mineral density and its determinants in diabetes: the Fremantle Diabetes Study,” Diabetologia, vol. 49, no. 5, pp. 863–871, 2006. View at Publisher · View at Google Scholar · View at Scopus
  69. A. Räkel, O. Sheehy, E. Rahme, and J. LeLorier, “Osteoporosis among patients with type 1 and type 2 diabetes,” Diabetes & Metabolism, vol. 34, no. 3, pp. 193–205, 2008. View at Publisher · View at Google Scholar · View at Scopus
  70. A. C. dos Santos, M. Roberto Cucê Nobre, A. Nussbacher, et al., “Predictors of the risk of falls among elderly with chronic atrial fibrillation,” Clinics, vol. 67, no. 4, pp. 305–311, 2012. View at Publisher · View at Google Scholar
  71. J. Semel, J. M. Gray, H. J. Ahn, H. Nasr, and J. J. Chen, “Predictors of outcome following hip fracture rehabilitation,” PM & R, vol. 2, no. 9, pp. 799–805, 2010. View at Publisher · View at Google Scholar · View at Scopus
  72. D. Lieberman, M. Friger, and D. Lieberman, “Rehabilitation outcome following hip fracture surgery in elderly diabetics: a prospective cohort study of 224 patients,” Disability and Rehabilitation, vol. 29, no. 4, pp. 339–345, 2007. View at Publisher · View at Google Scholar · View at Scopus
  73. S. N. Robinovitch, F. Feldman, Y. Yang, et al., “Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study,” The Lancet, vol. 381, no. 9860, pp. 47–54, 2012. View at Publisher · View at Google Scholar
  74. B. Najafi, R. T. Crews, and J. S. Wrobel, “Importance of time spent standing for those at risk of diabetic foot ulceration,” Diabetes Care, vol. 33, no. 11, pp. 2448–2450, 2010. View at Publisher · View at Google Scholar · View at Scopus
  75. H. Salsabili, F. Bahrpeyma, B. Forogh, et al., “Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes,” Journal of Rehabilitation Research and Development, vol. 48, no. 7, pp. 775–786, 2011. View at Publisher · View at Google Scholar
  76. S. Morrison, S. R. Colberg, M. Mariano, H. K. Parson, and A. I. Vinik, “Balance training reduces falls risk in older individuals with type 2 diabetes,” Diabetes Care, vol. 33, no. 4, pp. 748–750, 2010. View at Publisher · View at Google Scholar · View at Scopus
  77. R. L. Kruse, J. W. Lemaster, and R. W. Madsen, “Fall and balance outcomes after an intervention to promote leg strength, balance, and walking in people with diabetic peripheral neuropathy: “feet first” randomized controlled trial,” Physical Therapy, vol. 90, no. 11, pp. 1568–1579, 2010. View at Publisher · View at Google Scholar · View at Scopus
  78. T. A. Comans, S. G. Brauer, and T. P. Haines, “Randomized trial of domiciliary versus center-based rehabilitation: which is more effective in reducing falls and improving quality of life in older fallers?” Journals of Gerontology A, vol. 65, no. 6, pp. 672–679, 2010. View at Publisher · View at Google Scholar · View at Scopus
  79. M. W. Liu, W. C. Hsu, T. W. Lu, H. L. Chen, and H. C. Liu, “Patients with type II diabetes mellitus display reduced toe-obstacle clearance with altered gait patterns during obstacle-crossing,” Gait & Posture, vol. 31, no. 1, pp. 93–99, 2010. View at Publisher · View at Google Scholar · View at Scopus
  80. G. Grewal, R. Sayeeda, S. Yescheka, et al., “Virtualizing the assessment: a novel pragmatic paradigm to evaluate lower extremity joint perception in diabetes,” Gerontology, vol. 58, no. 5, pp. 463–471, 2012. View at Publisher · View at Google Scholar