Measures of Health and Function that Predict Future Falls (original) (raw)
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Journal of Nutrition, Health and Aging, 2010
Background: The aim of the study was to determine which risk factors were associated with the recurrence of falls among community-dwelling older adults. Methods: Based on a cross-sectional design, 1066 community-dwelling volunteers aged 65 and older were recruited. The use of psychoactive drugs, the number of drugs taken per day, the basic mobility assessed with the Timed Up & Go test (TUG), the maximal isometric voluntary contraction strength of hand, the lower limb proprioception, the distance binocular vision, the fear of falling and the history of falls during the past year were recorded. Subjects were separated into 4 groups based on the number of falls: 0, 1, 2 and > 2 falls. Results: Among the 395 (37.1%) fallers, 291 (27.3%) were single fallers and 104 (9.8%) were recurrent fallers (i.e., > 2 falls). The numbers of falls increased significantly with age (Incident Rate Ratio (IRR)=1.03, p<0.001), female gender (IRR=1.95, p<0.001), institutionalization (IRR=1.66, p=0.002), number of drugs taken per day (IRR=1.05, p<0.001), use of psychoactive drugs (IRR=1.29, p=0.009), increased time of TUG Test (IRR=1.02, p<0.001), use of a walking aid (IRR=1.59, p=0.002), and fear of falling (IRR=3.08, p<0.001). In addition, a high score at the handgrip test (IRR=0.97, p<0.001) and distance binocular vision (IRR=0.92, p<0.001) were associated with a decreased number of falls. After adjustment for potential confounders, only female gender (IRR=1.44, p<0.001), vision (IRR=0.95, p=0.006) and lower limb proprioception (IRR=0.95, p=0.046), and fear of falling (IRR=2.68, p<0.001) were still significantly associated with the number of falls. Conclusion. The current study shows that female gender, poor vision and lower limb proprioception, and fear of falling were associated with the recurrence of falls.
Risk of Falling and Associated Factors in Older Adults with a Previous History of Falls
International Journal of Environmental Research and Public Health, 2020
Falls in the elderly are one of the main geriatric syndromes and a clear indicator of fragility in the older adult population. This has serious consequences, leading to an increase in disability, institutionalization and death. The purpose of this cross-sectional study was to analyze the prevalence of risk of falling and associated factors in a population of 213 non-institutionalised, able older adults with a history of falling in the previous year. We used the following assessment tools: Questionnaire of the WHO for the study of falls in the elderly, Geriatric Depression Scale and Tinetti’s Gait and Balance Assessment Tool. Age, using ambulatory assistive devices, polymedication, hospital admission following a fall and depression were significantly associated with risk of falling. In order to prevent fall reoccurrence, community-based fall prevention programs should be implemented.
Journal of Clinical Nursing, 2009
Aim. We documented the number of falls and falls risk profile over two years to derive a falls risks prediction score. Background. Simple falls risk assessment tools not requiring equipment or trained personnel may be used as a first step in the primary care setting to identify older people at risk who may be referred for further falls risk assessment in special clinics. Design. Survey. Method. Men (n = 1941) and 1949 women aged 65 years and over living in the community were followed up for two years to document the number of falls. Information was collected regarding demography, socioeconomic status, medical history, functional limitations, lifestyle factors and psychosocial functioning. Measurements include body mass index, grip strength and stride length. Logistic regression was used to determine significant predictions of falls and to calculate predictive scores. Result. Twelve factors in men and nine factors in women were used to construct a risk score. The AUC of the receiver operating characteristic curve was >0AE70 for both men and women and a cut off score of ‡8 gave sensitivity and specificity values between 60-78%. The factors included chronic disease, drugs, functional limitation, lifestyle, education and psychosocial factors. When applied to future predictions, only low energy level and clumsiness in both hands in men and feeling downhearted in women, were significant factors. Conclusions. A risk assessment tool with a cut off score of ‡8 developed from a two-year prospective study of falls may be used in the community setting as an initial first step for screening out those at low risk of falls. Relevance to clinical practice. A simple tool may be used in the community to screen out those at risk for falls, concentrating trained healthcare professionals' time on detailed falls assessment and intervention for those classified as being at risk.
Age and Ageing, 2004
Objectives: (1) to examine consequences of falls in older men and women and (2) to examine risk factors for health service use and functional decline among older fallers. Methods: the study was performed within the Longitudinal Aging Study Amsterdam. In 1998/1999, potential risk factors were assessed during the third data collection. In 1999/2000, 204 community-dwelling persons (≥65 years) who reported at least one fall in the year before the interview, were asked about consequences of their last fall, including physical injury, health service use, treatment and functional decline (i.e. decline in functional status, social and physical activities). Results: as a consequence of falling, respondents reported physical injury (68.1%), major injury (5.9%), health service use (23.5%), treatment (17.2%), and decline in functional status (35.3%), and social (16.7%) and physical activities (15.2%). Using multivariate logistic regression, speciWc risk factors for health service use after falling could not be identiWed. Female gender (OR = 2.8, 95% CI = 1.5-5.1), higher medication use (OR = 1.5, 95% CI = 1.0-2.2) and depressive symptoms (OR = 1.9, 95% CI = 1.3-2.8) were independently associated with functional decline after falling. Depressive symptoms (OR = 2.0, 95% CI = 1.2-3.3) and falls inside (OR = 2.6, 95% CI = 1.1-6.5) were risk factors for decline in social activities, while female gender (OR = 2.7, 95% CI = 1.1-7.0) and depressive symptoms (OR = 1.9, 95% CI = 1.2-3.0) were risk factors for decline in physical activities after falling. Conclusions: almost 70% of the respondents suffered physical injury, almost one-quarter used health services and more than one-third suffered functional decline after falling. No risk factors were found for health service use needed after falling. Female gender, higher medication use, depressive symptoms and falls inside were risk factors for functional decline after falling.
Osteoporosis International, 2006
Introduction: The aim of the prospective study reported here was to develop a risk profile that can be used to identify community-dwelling elderly at a high risk of recurrent falling. Materials and methods: The study was designed as a 3-year prospective cohort study. A total of 1365 community-dwelling persons, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam participated in the study. During an interview in 1995/1996, physical, cognitive, emotional and social aspects of functioning were assessed. A follow-up on the number of falls and fractures was conducted during a 3year period using fall calendars that participants filled out weekly. Recurrent fallers were identified as those who fell at least twice within a 6-month period during the 3-year follow-up. Results: The incidence of recurrent falls at the 3-year follow-up point was 24.9% in women and 24.4% in men. Of the respondents, 5.5% reported a total of 87 frac-tures that resulted from a fall, including 20 hip fractures, 21 wrist fractures and seven humerus fractures. Recurrent fallers were more prone to have a fall-related fracture than those who were not defined as recurrent fallers (11.9% vs. 3.4%; OR: 3.8; 95% CI: 2.3-6.1). Backward logistic regression analysis identified the following predictors in the risk profile for recurrent falling: two or more previous falls, dizziness, functional limitations, weak grip strength, low body weight, fear of falling, the presence of dogs/cats in the household, a high educational level, drinking 18 or more alcoholic consumptions per week and two interaction terms (high education×18 or more alcohol consumptions per week and two or more previous falls × fear of falling) (AUC=0.71). Discussion: At a cut-off point of 5 on the total risk score (range 0-30), the model predicted recurrent falling with a sensitivity of 59% and a specificity of 71%. At a cut-off point of 10, the sensitivity and specificity were 31% and 92%, respectively. A risk profile including nine predictors that can easily be assessed seems to be a useful tool for the identification of community-dwelling elderly with a high risk of recurrent falling.
RISK FACTORS ASSOCIATED WITH THE OCCURRENCE OF FALLS IN THE LIFE CONTEXT OF THE ELDERLY (Atena Editora), 2022
A fall is an unintentional displacement of the body, with common occurrences in the elderly, constituting the third cause of death in individuals aged sixty or more. Incidences of falls are indicative of underlying problems, requiring attention from health professionals and family members. It is postulated, then, to identify the risk factors associated with the occurrence of falls in the context of the lives of the elderly, based on an integrative literature review. The following inclusion criteria were adopted: articles published from 2010 to 2020, in Portuguese, English and Spanish, which included in their titles and/or abstract aspects related to the proposed theme, as well as made available in full, free of charge and online. In this sense, factors may be associated with falls in the elderly: the use of assistive devices, environmental risks, health conditions such as rheumatism, muscle weakness, vertigo, impaired gait and balance, visual and auditory disorders, cognitive and sensory impairments. , orthostatic hypotension, diabetes mellitus, common mental disorder, osteoporosis, asthma, bronchitis, dizziness, insomnia and emphysema. It is concluded that falls are recurrent in the female elderly population and cause dysfunctions, limitations in daily activities, fear of falling, reduced functional mobility and injuries. Therefore, risk factors for falls in the elderly are associated with quality of life and efforts must be made to reduce their incidence, such as identifying factors contributing to falls and raising awareness about the subject and its consequences for the health of the elderly.
BMC Geriatrics, 2008
The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data.