Multimorbidity classes and risk of falls

Four multimorbidity classes emerge

Latent class analysis in hospitalized adults aged ≥70 years with multimorbidity and polypharmacy identifies four classes: metabolic, cardiovascular, less multimorbid, and highly multimorbid.

Cardiovascular class shows higher fall rate

During 12-month follow-up, 25% report ≥1 fall and 55% of falls are injurious. The cardiovascular class shows a 25% higher fall rate versus the less multimorbid reference class.

Falls assessment considers multimorbidity heterogeneity

Counting comorbidities alone is limiting because conditions differ in weight and clustering. Falls assessment therefore accounts for multimorbidity heterogeneity, particularly in patients with cardiovascular disease.

The continuing education session “Multimorbidity classes and risk of falls,” organized by Klinik Barmelweid and presented by Priv.-Doz. Patricia Chocano, addresses the association between multimorbidity patterns and falls in older adults. Using data from the European OPERAM cohort of hospitalized patients aged 70 years or older with multimorbidity and polypharmacy, the study applies latent class analysis to ICD-10-based chronic disease groups to identify four multimorbidity phenotypes: metabolic syndrome, cardiovascular, highly multimorbid, and digestive-neuroskeletal/less multimorbid. Falls are assessed prospectively over 12 months by structured telephone follow-up, and 25% of participants report at least one fall, of which more than half are injurious. Compared with the digestive-neuroskeletal/less multimorbid reference class, the cardiovascular phenotype shows a 25% higher fall rate, while the association with injurious falls points in the same direction but does not reach statistical significance. No significant differences are found for recurrent falls across the multimorbidity classes. The presentation emphasizes that counting comorbidities alone is insufficient, as multimorbidity is heterogeneous and different disease clusters may confer different fall risks. As possible explanatory mechanisms for the cardiovascular phenotype, Priv.-Doz. Chocano discusses hemodynamic instability, reduced physical reserve, and medication-related effects, while also noting the observational design, residual confounding, and self-reported falls as key limitations.