Impact of coexisting lumbar spinal stenosis and sleep disorders on fall risk: a cross-sectional study of community-dwelling residents (locomotive syndrome and health outcome in Aizu cohort study)

Eur Spine J. 2025 Aug 9. doi: 10.1007/s00586-025-09208-x. Online ahead of print.

ABSTRACT

PURPOSE: Lumbar spinal stenosis (LSS) and sleep disorders increase the risk of falls in older adults; however, their combined impact remains unclear. This study aimed to investigate the individual and combined effects of LSS and sleep disorders on fall risk in a community-dwelling older population.

METHODS: We analysed cross-sectional data of 1,101 adults aged ≥ 65 years from the 2008 Locomotive Syndrome and Health Outcomes in Aizu Cohort Study. LSS and sleep disorders were assessed using self-administered questionnaires. The participants were classified into four groups: N/N (neither condition), L/N (LSS only), N/S (sleep disorder only), and L/S (both conditions). The study outcome was the fall history in the past year. Multivariable logistic regression with multiple imputations (m = 20) was conducted after adjusting for age, sex, overweight, hypertension, diabetes, smoking, depression, and physical activity. Sensitivity analyses were performed using alternative definitions of LSS and sleep disorder.

RESULTS: The fall rate was 21.3%. The adjusted odds ratios (ORs) were 1.54 (95% confidence interval, 1.02-2.33) in L/N and 2.11 (1.05-4.26) in L/S, compared with N/N. N/S showed no significant association. Among men, both L/N (OR, 2.09) and L/S (OR, 2.41) were significantly associated with falls, whereas no associations were observed in women. The sensitivity analyses yielded consistent results.

CONCLUSION: LSS is associated with an increased risk of falls, and the coexistence of sleep disorders may further increase this risk, particularly in men. Fall prevention in patients with LSS should address both pain and sleep-related factors.

PMID:40782199 | DOI:10.1007/s00586-025-09208-x