Interaction effects of alcohol consumption and dizziness/vertigo on fall risk in psychiatric Inpatients: a cross-sectional study

TL;DR

This study finds that alcohol consumption combined with dizziness/vertigo increases fall risk in psychiatric patients.

Contribution

The study is the first to quantify the combined effect of alcohol consumption and dizziness/vertigo on fall risk in psychiatric inpatients.

Findings

Alcohol consumption and dizziness/vertigo interact to increase fall risk in psychiatric patients.

Antiepileptic medication, BMI, and diagnosis type are also independent fall risk factors.

Additive interaction measures showed strong synergy between alcohol and dizziness/vertigo.

Abstract

Patients with mental disorders have a high incidence of falls and fall-related injuries, and although a history of alcohol consumption and dizziness/vertigo symptoms are assessed at the admission stage, their combined effect on fall risk has not been adequately quantified.

This exploratory study aimed to investigate the potential interaction between a history of alcohol consumption and dizziness/vertigo on the occurrence of falls among patients with mental disorders.

A cross-sectional study was conducted among patients hospitalized in a psychiatric specialty hospital. Patients were divided into fall and non-fall groups. Data were analyzed using a Chi-square test and Multivariate logistic regression. Multiplicative and additive models were applied to calculate the interactions of a history of alcohol consumption and dizziness/vertigo, respectively.

2210 participants were included, 194 in the falls group and 2016 in the non-falls group. Multivariate analysis demonstrated that the utilization of antiepileptic medication, a history of alcohol consumption, dizziness/vertigo, body mass index (BMI) and diagnostic type were independent risk factors for falls in patients diagnosed with mental disorders. The multiplicative interaction analysis revealed a statistically significant interaction between a history of alcohol consumption and the presence of dizziness/vertigo on the incidence of falls among patients with mental disorders, after controlling for relevant variables(P<0.05). The additive interaction results suggested that the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (API), and the synergy index (SI) were 7.470 (95% CI: 2.701-12.239), 0.674 (95% CI: 0.511-0.838), and 3.864 (95% CI: 2.040-7.320) after adjusting for relevant variables.

There is a potential positive interaction between a history of alcohol consumption and dizziness/vertigo on the occurrence of falls in patients with mental disorders. Given the exploratory nature of this study and the small sample size of the co-exposed group, this conclusion requires validation in larger, prospective studies.