# Influence of psychosocial and health-seeking behaviour on the risk of falling among persons living with type 2 diabetes in the Malaysian Elders Longitudinal Research (MELoR) cohort

## TL;DR

This study shows that psychological factors like depression and stress increase the risk of falls in older adults with type 2 diabetes in Malaysia.

## Contribution

The study identifies psychosocial and health-seeking behavior influences on fall risk specifically in diabetic older adults in Malaysia.

## Key findings

- Diabetics had a higher risk of falls compared to non-diabetics at baseline and follow-up.
- Depression, anxiety, or stress were significantly associated with falls in diabetics after adjusting for key factors.
- Psychosocial support may help reduce fall risk and improve outcomes for diabetic older adults.

## Abstract

Older persons with diabetes have an increased falls risk that could lead to serious complications including death.

To determine the influence of psychosocial factors and health-seeking behaviour on the risk of falling among individuals with type 2 diabetes.

This prospective study included community-dwelling adults aged ≥55 years selected through stratified random sampling from three neighbouring parliamentary constituencies. Data was collected at baseline in 2013–2015 with computer-assisted home-based interviews and follow-up in 2019 via telephone interviews.

Data on diabetes status and falls were available for 908 participants at baseline and follow-up. Diabetes was present in 42.2% of included participants at follow-up, of whom 22.8% at baseline and 25.3% at 5-year follow-up had at least one fall within the last 12 months. Diabetics had a higher risk of falls at baseline (OR: 1.484; 95% CI: 1.060–2.077) and follow-up (OR: 1.424; 95% Cl: 1.038–1.954) than non-diabetics. It was found that female gender, arthritis, alcohol and presence of depression anxiety or stress were associated with increased risk of falls in diabetics. The presence of any depression, anxiety or stress remained significantly associated with falls in diabetics (OR: 1.947; 95% Cl: 1.115–3.402) after adjustments for age, gender, ethnicity, and education but this relationship was attenuated after additional adjustment for arthritis (OR: 1.763; 95% CI: 0.996–3.122).

Our findings suggest that psychological issues are significantly associated with increased risk of falls at five-year follow-up in individuals aged 55 years and over with diabetes. These findings highlight the potential importance of psychosocial support among diabetics to reduce the risk of falls, improve patient outcomes and quality of life.