Analysis of risk factors associated with fall risk patients with cerebral small vessel disease who can walk independently

Abstract

Objective To explore the risk factors related to higher fall risk in patients with cerebral small vessel disease (CSVD) who can walk independently. Methods A total of 226 patients with CSVD treated in Department of Neurorehabilitation, Tianjin Huanhu Hospital from December 2017 to December 2020 were included. Clinical data (including sex, age, height, weight, past medical history, resting blood pressure, fasting blood glucose and glycosylated hemoglobin) were collected. Lacunar infarct (LACI) and white matter hyperintense [deep white matter hyperintense (DWMH) and periventricular white matter hyperintense (PWMH)] were observed by MRI, carotid intima⁃media thickness (IMT) was measured by color Doppler ultrasound. Postural instability was assessed based on One⁃Leg Standing Test (OLST). Univariate and multivariate forward Logistic regression analysis were used to screen the risk factors of higher fall risk in patients with CSVD who can walk independently. Results According to OLST time, the patients were divided into high fall risk group (≤10 s, 104 cases) and low fall risk group (＞10 s, 122 cases). Univariate and multivariate forward Logistic regression analysis suggested that age (OR=1.053, 95%CI: 1.006-1.101; P=0.026), diabetes history (OR=2.910, 95%CI: 1.288-6.577; P=0.010), DWMH Fazekas score 1 (OR=7.329, 95%CI: 1.775-30.272; P=0.006), Fazekas score 2 (OR=8.004, 95%CI: 1.905-33.627; P=0.005) and Fazekas score 3 (OR=23.884, 95%CI: 4.205-135.657; P=0.000) were the risk factors of higher fall risk patients with CSVD who can walk independently. Conclusions For patients with CSVD, especially those who appear to have a normal gait and can walk independently, there is still a high risk of falling, which may be independently related to the age, diabetes history and DWMH.

Keywords

• cerebral small vessel diseases
• accidental falls
• risk factors
• logistic models