Association between respiratory tract infections and incidence of falls in nursing home residents

INTRODUCTION Falls are complex incidents caused by a combination of intrinsic impairments and disabilities with or without accompanying environmental hazards.
OBJECTIVES The aim of the study was to assess the relationship between respiratory tract infections (RTIs) and the incidence of falls, and to further link the history of falls to functional status in nursing homes residents. 
PATIENTS AND METHODS The study involved 255 residents at 3 nursing homes aged 65 years and older. Falls and RTIs were registered during 1 year, and, afterwards, a comprehensive geriatric assessment was performed in each subject.
RESULTS Falls occurred in 104 subjects, and 17 falls resulted in a fracture. The waist‑to‑hip ratio (WHR) was lower among subjects with fractures compared with those without fractures. Subjects with a fracture in history had a significantly worse functional status in terms both of basic and instrumental daily activities. Nursing home residents with a history of falls more often suffered from infections than those without such history (1.53 ±1.31 vs. 1.03 ±1.17, respectively, P <0.001). Similarly, subjects with a history of fractures more often suffered from infections than those without such history (1.82 ±1.07 vs. 1.19 ±1.26; P = 0.012). After adjustment for other covariates in a multivariate model, RTIs remained an independent predictor of falls and fractures. 
CONCLUSIONS The risk of falls and fractures in nursing home residents is associated with the occurrence of RTIs. A low WHR is a risk factor for falls with fractures. Older subjects with a history of fracture are characterized by a worse functional status. Preventing infections may probably reduce the number of falls and fractures in older nursing homes residents.