Abstract
BackgroundFew studies on fall risk factors use long-recommended methods for analysis of recurrent events. Previous falls are the biggest risk factor for future falls, but few fall studies focus on the youngest-old.AimsThis study’s objective was to apply Cox regression for recurrent events to identify factors associated with injurious falls in the youngest-old.MethodsParticipants were community-dwelling residents of southern Sweden (n = 1,133), aged 59–67 at baseline (median 61.2), from the youngest cohorts of the larger Good Aging in Skåne (GÅS) study. Exposure variable data were collected from baseline study visits and medical records. Injurious falls, defined as emergency, inpatient, or specialist visits associated with ICD-10 fall codes during the follow-up period (2001–2011), were gathered from national and regional registries. Analysis was conducted using time to event Cox Regression for recurrent events.ResultsA majority (77.1 %) of injurious falls caused serious injuries such as fractures and open wounds. Exposure to nervous system medications [hazard ratio (HR) 1.40, 95 % confidence interval (CI) 1.03–1.89], central nervous system disease (HR 1.79, CI 1.18–2.70), and previous injurious fall(s) (HR 2.00, CI 1.50–2.68) were associated with increased hazard of injurious fall.ConclusionsRegression for recurrent events is feasible with typical falls’ study data. The association of certain exposures with increased hazard of injurious falls begins earlier than previously studied. Different patterns of risk factors by age can provide insight into the progression of frailty. Tailored fall prevention screening and intervention may be of value in populations younger than those traditionally screened.
Highlights
Falls in older populations are a common issue, with approximately one-third of community-dwelling individuals over the age of 65 falling each year [1,2,3,4,5,6,7,8]
One factor consistently found to be associated with falls is a history of previous falls, meaning that delaying or preventing early falls may reduce the number of future falls
Using a longitudinal cohort design, we studied the association between injurious falls and selected exposure variables including symptoms, diagnoses, physical performance, and medications in the youngest-old
Summary
Falls in older populations are a common issue, with approximately one-third of community-dwelling individuals over the age of 65 falling each year [1,2,3,4,5,6,7,8] Many of these falls result in injury or death [9,10,11,12], and those who fall are more likely to experience worsened function [13, 14] and have a higher risk of transition to sheltered housing [15, 16]. Aims This study’s objective was to apply Cox regression for recurrent events to identify factors associated with injurious falls in the youngest-old.
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