Combined effect of falling difficulty and cardiovascular diseases on the risk of all-cause and cardiovascular mortality in older adults: an analysis of the National Health and Nutrition Examination Survey

Abstract

Purpose: Older adults with cardiovascular diseases (CVD) are prone to falls. This study aimed to analyze the combined effect of falling difficulty and CVD on the risk of all-cause- and CVD mortality in older adults.

Methods: In this retrospective cohort study, people aged ≥60 years with information on falling difficulty and CVD from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were selected. Multivariable Cox proportional hazards regression model was used to assess the associations of falling difficulty and CVD with all-cause- and CVD mortality.

Results: A total of 1409 participants were included, of whom 868 (58.1%) participants died, and 237 (15.0%) died of CVD. The mean age of participants was 72.1 (0.3) years and 825 (64.7%) were female. Older adults with falling difficulty or CVD were associated with an increased risk of all-cause- and CVD mortality. Older adults in the no falling difficulty & CVD group [hazard ratio (HR) = 1.45, 95% confidence interval (CI) 1.19-1.78], the falling difficulty & no CVD group (HR = 1.45, 95%CI 1.12-1.89), and the falling difficulty & CVD group (HR = 2.13, 95%CI 1.77-2.56) were related to a higher risk of all-cause mortality compared to those in the no falling difficulty & no CVD group. The combined effect of falling difficulty and CVD was positively correlated with the risk of all-cause mortality (HR = 1.26, 95%CI: 1.18-1.34; P-trend <0.001) and CVD mortality (HR = 1.36, 95%CI: 1.18-1.56; P-trend <0.001).

Conclusion: The combined effect of falling difficulty and CVD was positively associated with the risk of all-cause- and CVD mortality in older adults.

Keywords: Cardiovascular diseases; Combined effect; Falling difficulty; Mortality; NHANES.