Thesis
Fall risks among older adult farmers
University of Iowa
Master of Science (MS), University of Iowa
Spring 2024
DOI: 10.25820/etd.007508
Abstract
Introduction: This thesis investigated fall risks, including medication usage and fall history, among older adult farmers. While there is an abundance of research on the older adult population regarding fall risks and prevention, there is minimal research on falls specific to older adult farmers. The older adult farmer population is at heightened risk of falls, compared to their non-farming counterparts, due to increased occupational hazards. There is also literature identifying older farmers as having high rates of injury and mortality. However, little research has been published examining risk factors specific to falls among older farmers. This thesis research used data from a large pragmatic trial, Medication Empowerment and Deprescribing for Safety (MEDS; CDC Grant #: U01CE002961), to identify fall risk factors among older adults working in agriculture.
Methods: The study population was drawn from the 396 MEDS study participants. The eligibility criteria for participating in the MEDS study included: (1) being at least 60 years of age, (2) not having an Alzheimer’s or dementia diagnosis, (3) living independently (e.g., not living in assisted living, nursing home), (4) not currently in cancer treatment, (5) receiving primary care services at a rural clinic within a Midwest faith-based not-for-profit system of healthcare facilities and services, and (6) currently being prescribed and taking an opioid, benzodiazepine, anticholinergic, or gabapentinoid with the intention of taking the medication for at least another 30 days. I coded all farming and farming adjacent occupation titles into the “Farmer” category (n=27) based on an open-ended question asking participants about their occupation. Additionally, I wanted to create a “Non-Farmer” category for a comparison group using a 1:1 match ratio on gender and hospital. The three groups of fall risk variables analyzed in this thesis included: risk factors for falls among older adults, over the counter and prescription medications, and fall history and fall perceptions variables. Differences in fall risk between “Farmers” and "Non-Farmers” were analyzed using the McNemar Test for categorical variables and the Wilcoxon Signed Rank Test for continuous variables.
Results: A large percentage of farmers were taking opioids, bladder medications, and had polypharmacy, which is taking 5 or more prescription or over the counter medications. Additionally, farmers had a higher median number of falls compared to non-farmers despite lower levels of self-reported pain and less concern around falling. This showcases the need for farmer-specific falls prevention programs and for implementing falls referral systems within rural healthcare networks to help mitigate the falls burden among older adult farmers. Our findings further suggest the need for increased education from healthcare providers so that farmers have a greater understanding of why medication adherence is important. This was demonstrated by the Beliefs About Medications Questionnaire where most farmers’ concerns about taking medications such as side effects and impact on daily life outweighed the perceived benefits.
Conclusion: This thesis is one of the first studies examining risk factors for falls among older farmers and can be used to help inform future falls research on older adult farmers. Prevention and education measures should be tailored specifically to the older adult farming population. Finally, there is a need for a falls referral system to be implemented within rural healthcare networks so healthcare providers can offer high risk older farmers options for community-based falls prevention programming.
Details
- Title: Subtitle
- Fall risks among older adult farmers
- Creators
- Madison Meyer
- Contributors
- Carri Casteel (Advisor)Jonathan Davis (Committee Member)Korey Kennelty (Committee Member)Diane Rohlman (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Occupational and Environmental Health
- Date degree season
- Spring 2024
- Publisher
- University of Iowa
- DOI
- 10.25820/etd.007508
- Number of pages
- ix, 57 pages
- Copyright
- Copyright 2024 Madison Meyer
- Grant note
- I would like to acknowledge the Heartland Center for providing me fellowship funding throughout my time in the M.S. Occupational and Environmental Health program (CDC/NIOSH Grant #: T42 OH008491). Additionally, the University of Iowa Injury Prevention Research Center for helping advance my training and education within the field of Occupational Injury Prevention. Furthermore, I would like to thank Dr. Jon Davis for help with the statistical analysis and coding process. Also, I would like to acknowledge my thesis committee for their expert advice throughout this learning process. Finally, I’d like to acknowledge the Medication Empowerment and Deprescribing for Safety (MEDS) (CDC Grant #: U01CE002961) for allowing me to perform secondary analysis on MEDS study data. (iii)
- Language
- English
- Date submitted
- 03/25/2024
- Description illustrations
- Tables, graphs
- Description bibliographic
- Includes bibliographical references (pages 35-40).
- Public Abstract (ETD)
The main goal of this thesis was to compare medication usage and other fall risk factors among older adult farmers and their non-farmer rural counterparts. The research is well established for falls among older adults, but there is minimal research examining falls among older adult farmers. The older adult farmer population is continuing to grow as the average age of farmers continues to increase. Understanding fall risks in this population is important.
The main findings from this thesis were that older adult farmers were experiencing more falls, and the majority had polypharmacy which is defined as taking 5 or more prescription or over the counter medications at once. Additionally, about one-fourth of farmers were taking opioids and bladder medications, both of which increase fall risk. Despite the farming population being healthy overall in this study, their concerns regarding taking medications outweighed the perceived benefits. Thus, there is a need for more education from physicians and pharmacists regarding why they are taking a certain medication and why adherence is important. Overall, there is a need to expand research on falls among older adult farmers to help mitigate the falls burden within this growing population.
- Academic Unit
- Occupational and Environmental Health
- Record Identifier
- 9984647648802771
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