Risk factors of geriatric syndromes in Korean population

Background: This study was conducted to identify the risk factors of geriatric syndromes including fall-related fractures, delirium, incontinence, and pressure ulcers using the Korean nationwide claims data. Methods: The claims data of the Korean National Health Insurance Service between 2006 and 2015 were used. We included older people, 65 years of age and older, who underwent a national health check-up in 2007 or 2008. Geriatric syndromes were limited to 4 types (fall-related fractures, delirium, incontinence, and pressure ulcers), which can be identified via diagnostic codes. Results: The risks of fall-related fractures, delirium, incontinence, and pressure ulcers all increased with increasing age, and the risks of delirium and incontinence increased more in women than in men. Exercise decreased the risks of all 4 types of geriatric syndrome, and increase in body mass index decreased the risks of fall-related fractures, delirium, and pressure ulcers while increasing the risk of incontinence. The adjusted hazard ratios of smoking and alcohol intake three times or more a week in relation to fall-related fractures, delirium, incontinence, and pressure ulcers were 1.46, 1.16, 0.99, and 1.33, respectively, and 1.04, 1.12, 0.93, 0.98, respectively. Conclusion: This study showed that increasing age, major surgery within 6 months, and polypharmacy increase the risk of 4 types of geriatric syndrome in Korea. Comorbidity (especially dementia) was identified as a very important risk factor. Exercise had protective effects against the 4 types of geriatric syndrome studied. However, contradictory results were found for smoking and alcohol intake, which require further study.